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
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
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| 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) | 0.003 | 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 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".