Disease clearance in ulcerative colitis: A new therapeutic target for the future

World J Gastroenterol. 2024 Apr 7;30(13):1801-1809. doi: 10.3748/wjg.v30.i13.1801.

Abstract

Advancements in murine modeling systems for ulcerative colitis have diversified our understanding of the pathophysiological factors involved in disease onset and progression. This has fueled the identification of molecular targets, resulting in a rapidly expanding therapeutic armamentarium. Subsequently, management strategies have evolved from symptomatic resolution to well-defined objective endpoints, including clinical remission, endoscopic remission and mucosal healing. While the incorporation of these assessment modalities has permitted targeted intervention in the context of a natural disease history and the prevention of complications, studies have consistently depicted discrepancies associated with ascertaining disease status through clinical and endoscopic measures. Current recommendations lack consideration of histological healing. The simultaneous achievement of clinical, endoscopic, and histologic remission has not been fully investigated. This has laid the groundwork for a novel therapeutic outcome termed disease clearance (DC). This article summarizes the concept of DC and its current evidence.

Keywords: Clinical remission; Disease clearance; Endoscopic remission; Histological remission; Inflammatory bowel disease; Mucosal healing; Ulcerative colitis.

Publication types

  • Review
  • Editorial

MeSH terms

  • Animals
  • Colitis, Ulcerative* / diagnosis
  • Colitis, Ulcerative* / therapy
  • Colon / drug effects
  • Colon / pathology
  • Disease Models, Animal*
  • Disease Progression
  • Humans
  • Intestinal Mucosa* / drug effects
  • Intestinal Mucosa* / metabolism
  • Intestinal Mucosa* / pathology
  • Mice
  • Molecular Targeted Therapy / methods
  • Remission Induction* / methods
  • Treatment Outcome