期刊
GUT
卷 65, 期 3, 页码 408-414出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/gutjnl-2015-309598
关键词
-
资金
- MRC [G0200231] Funding Source: UKRI
- Medical Research Council [G0200231] Funding Source: researchfish
- Medical Research Council [G0200231] Funding Source: Medline
Background Endoscopic mucosal healing is an established treatment target for UC, yet the value of achieving histological remission remains unclear. Aims To evaluate histological remission compared to endoscopic mucosal healing for predicting patient outcomes in UC. Methods Blinded assessment of endoscopic and histological measures of disease activity was performed on patients with established UC at baseline. Concordance and prognostic values of endoscopic mucosal healing (defined by Baron score <= 1) and histological remission (defined by Truelove and Richards' index) for predicting outcomes of corticosteroid use, hospitalisation and colectomy were determined over a median 6 years follow-up, including. statistics and Cox regression multivariate analysis. Results 91 patients with UC were followed up for a median 72 months (IQR 54-75 months). Overall, concordance between endoscopic and histological remission was moderate (kappa = 0.56, 95% CI 0.36 to 0.77); 24% patients had persistent inflammation despite endoscopic remission. Histological remission predicted corticosteroid use and acute severe colitis requiring hospitalisation over the follow-up period (HR 0.42 (0.2 to 0.9), p=0.02; HR 0.21 (0.1 to 0.7), p=0.02; respectively), whereas endoscopic mucosal healing did not (HR 0.86, 95% CI 0.5 to 1.7, p0.65; HR 0.83 95% CI 0.3 to 2.4, p0.74; respectively). Conclusions Histological remission is a target distinct from endoscopic mucosal healing in UC and better predicts lower rates of corticosteroid use and acute severe colitis requiring hospitalisation, over a median of 6 years of follow-up. Our findings support the inclusion of histological indices in both UC clinical trials and practice, towards a target of 'complete remission'.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据