A213 REDEFINING MILD-MODERATE ULCERATIVE COLITIS: PATIENTS WITH ENDOSCOPIC MAYO SCORE 1 AND ACTIVE HISTOLOGIC INFLAMMATION HAVE SIMILAR OUTCOMES TO PATIENTS WITH MAYO SCORE 2
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Abstract Background Mild-to-moderate ulcerative colitis (UC) is conventionally defined as a total Mayo Clinic score of at least 4, with a Mayo Endoscopic Score (MES) of 2 and a Rectal Bleeding Score (RBS) of at least 1. Historically, endoscopic improvement with treatment has been defined as MES 0 or 1. However, studies have shown differences in prognosis between these two subsets of patients, with those who attain MES 1 reported to have higher rates of relapse. Patients with MES 1 and histologically active disease are currently excluded from contemporary clinical trials based on prevailing inclusion criteria. Consequently, insight into improving therapeutic outcomes for this patient population remains limited. Aims This study aims to explore whether UC patients with lower endoscopic burden but active histology have comparable outcomes to those with “conventional” mild-moderate UC. Methods This was a post-hoc analysis from the VARSITY study. Patients who completed induction (at week 14) with mild-moderate UC based on the conventional definition were compared to patients with histologically active MES 1 for achieving histo-endoscopic mucosal improvement (HEMI) at week 52, defined as Mayo endoscopic subscore ≤ 1 and Geboes highest grade < 3.2. Secondary outcomes included endoscopic remission (ER) (Mayo endoscopic subscore of 0), histologic improvement (Geboes highest grade < 3.2) and clinical remission (CR) (total Mayo score ≤ 2 and no subscore >1 on any of the four subcomponents). Histologically active disease was defined as Geboes highest grade > 3.2 (>50% of neutrophil crypt involvement in the epithelium). Results Week 52 outcomes were comparable among patients with mild-moderate UC compared to those with histologically active disease and MES of 1. At week 52, a similar proportion of patients achieved HEMI [19/79 (24.1%) vs. 28/113 (24.8%), p=0.908], ER [23/79 (29.1%) vs. 35/113 (31.0%), p=0.782], histologic improvement [23/79 (29.1%) vs. 36/113 (31.9%), p=0.685] and CR [38/79 (48.1%) vs. 66/113 (58.4%), p=0.158]. Conclusions Disease outcomes in patients with MES 1 and a Geboes score > 3.2 were comparable to those with conventional mild-to-moderate UC. These results highlight the need for clinical trialists to revisit and expand the current definition of mild-to-moderate UC. Further validation of these findings in other patient cohorts is recommended. Funding Agencies None
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 it