P0502 Impact of Endoscopic and Histologic Activity on Disease Relapse in Ulcerative Colitis: 3-year and 5-year follow-up
Bibliographic record
Abstract
Abstract Background Endoscopic healing in patients with ulcerative colitis predicted higher rates of clinical remission at 12 months follow-up. Meanwhile, active histologic disease did not affect time to clinical relapse in patients with UC who achieved endoscopic remission while the presence of basal plasmacytosis was associated with relapse. [1] We aim to evaluate the impact of baseline endoscopic and histological healing on long-term clinical relapse as well as the rates of UC-related emergency room (ER) visits, hospitalizations and surgery. Methods This prospective observational study was conducted at the Inflammatory Bowel Disease (IBD) Centre of McGill University Health Centre (MUHC) July 2012 to July 2020 and included all adult UC patients undergoing a colonoscopy with biopsies for disease assessments. Patient must have been in clinical remission with a stable dose of medication for at least 3 months prior to enrolment. Patients were followed every 3 months in the first year then every 6-12 months to assess disease relapse, defined as a partial Mayo score (PMS) >2. Active endoscopic disease was defined as Mayo endoscopic score (MES) of 2 or 3. Active histological disease was defined as a Geboes score ≥3.1 (epithelial neutrophils with or without crypt destruction/erosions). Results A total of 253 patients were included in this study. At the 3-year follow-up, baseline active endoscopic and histological disease did not predict clinical relapse. However, baseline endoscopy with a EMS of 0 (compared to 1-3) showed a trend towards significance in predicting relapse (P = 0.08). Multivariate analysis adjusting for age, gender, height, and smoking status remained non-significant (P = 0.0837, 95% CI 0.29–1.08). At 5 years, baseline histological activity did not predict risk of clinical relapse, however, endoscopy with EMS 0 significantly predicted clinical relapse (P = 0.0080), with multivariate analysis confirming this (P = 0.0110, 95% CI 0.27–0.84). Baseline endoscopy with EMS 1-3 was linked to increased ER visits at 3 years (P = 0.02), but not at 5 years (P = 0.7618). Histological disease activity was not linked to increased ER visits at 3 and 5 years. Neither baseline endoscopy nor histology predicted the risk of hospitalisation or surgery at either follow-up (P > 0.05). Conclusion Active histologic disease did not predict long-term clinical relapse at 3- or 5-years point. On the other hand, baseline endoscopic activity of EMS of 0 compared to 1-3, only predicted clinical relapse at 5 years and IBD-related ER visits at 3 years. This long-term follow up data questions the additional role of histology in patient with complete endoscopic healing. References 1.Bessissow T, Kron CM, Marcus V, Lemieux C, Laneuville J, Afif W, Wild G, Lakatos PL, Brassard P, Bitton A. Impact of Endoscopic and Histologic Activity on Disease Relapse in Ulcerative Colitis. Am J Gastroenterol. 2022 Oct 1;117(10):1632-1638. doi: 10.14309/ajg.0000000000001912. Epub 2022 Jul 21. PMID: 35862833.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".