Assessing inflammation and predicting relapse in ulcerative colitis is more accurate when performed by IBD specialized gastroenterologists
Madeline Alizadeh, Lauren A George, Ameer Abutaleb, Wenqing Cao, Bruce D Greenwald, Harris T Feldman, Shien Hu, David Hudesman, Frances Onyimba, Suparna Sarkar, Kristen Stashek, Katherine Sun, Uni Wong, Samantha Zullow, Jordan Axelrad, Raymond K CrossAbstract
Background
Ulcerative colitis is monitored through clinical, laboratory, endoscopic, and histologic measures. Persistence of histologic inflammation despite clinical and endoscopic remission is associated with disease flare.
Methods
We compared the identification of clinically significant histologic inflammation by general and IBD-specialized gastroenterologists (GI) using a simplified binary scoring system and looked at associations with disease relapse.
Results
Both general and IBD-specialized GIs identified significant inflammation associated with relapse, though IBD-specialized GIs scoring had stronger correlations with relapse.
Conclusions
Our findings suggest simple histologic assessment can inform risk stratification, and further work is needed to optimize monitoring patients with histologic inflammation despite endoscopic remission.