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Clinical significance of histologic healing in IBD: evidence from randomized controlled trials (RCT) and real world (RW) data

2025-05Journal article Restricted access
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dc.contributor.authorEstevinho, Maria Manuela
dc.contributor.authorRoseira, Joana
dc.contributor.authorTeixeira, Pedro Vilela
dc.contributor.authorDignass, Axel
dc.contributor.authorMagro, Fernando
dc.date.accessioned2025-05-19T09:33:22Z
dc.date.available2025-05-19T09:33:22Z
dc.date.issued2025-05
dc.description.abstractHistologic mucosal healing (HMH) has emerged as a crucial target in managing inflammatory bowel disease, complementing the established goal of endoscopic mucosal healing. This review evaluates the significance of HMH in both Crohn's disease (CD) and ulcerative colitis (UC). In UC, strong evidence shows that HMH correlates with improved long-term outcomes, including reduced hospitalization rates, and decreased need for corticosteroids and colectomy. Histologic healing is increasingly being incorporated as an endpoint in RCTs. Small-molecule therapies, such as S1P modulators and Jak inhibitors, have demonstrated particular efficacy in achieving HMH in UC. Real-world evidence (RWE) further supports HMH's utility as a predictive marker for favorable clinical outcomes in UC. In CD, however, HMH's role is less clear, given challenges in assessing and standardizing histologic healing. RCTs, such as SERENITY and VIVID, show that advanced therapies can achieve HMH in CD, though inconsistent histologic scoring and remission criteria complicate conclusions. Some studies suggest that histologic remission at induction may predict sustained remission, but real-world data offer mixed results regarding its prognostic value. This review provides an overview of current literature, emphasizing the need for standardized histologic assessment and extended studies, particularly for CD, while affirming HMH's growing importance in achieving deeper remission in UC. (c) 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.eng
dc.identifier.doi10.1016/j.dld.2024.11.009
dc.identifier.issn1590-8658
dc.identifier.urihttp://hdl.handle.net/10400.1/27130
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.hasversionhttps://www.dldjournalonline.com/article/S1590-8658(24)01098-3/fulltext
dc.relation.ispartofDigestive and Liver Disease
dc.rights.uriN/A
dc.subjectCrohn's disease
dc.subjectEndpoints
dc.subjectHistology
dc.subjectTherapeutic management
dc.subjectUlcerative colitis
dc.titleClinical significance of histologic healing in IBD: evidence from randomized controlled trials (RCT) and real world (RW) dataeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage518
oaire.citation.issue5
oaire.citation.startPage511
oaire.citation.titleDigestive and Liver Disease
oaire.citation.volume57
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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