Patients with ulcerative colitis that have endoscopic Mayo score 1 and active histologic inflammation have similar outcomes to mild-moderate patients with Mayo score 2: a post hoc analysis of the VARSITY trial
Bibliographic record
Abstract
BACKGROUND: Mild-moderate ulcerative colitis (UC) in clinical trials has been defined as an adapted Mayo Clinic score ≥4 with a Mayo endoscopic score (MES) of 2 and rectal bleeding score ≥1. This study aims to explore whether UC patients with lower endoscopic burden but active histology have similar outcomes to those with 'conventional' mild-moderate UC. METHODS: This was a post hoc analysis from the treat-through VARSITY study ( Clinicaltrial.gov : NCT02497469). 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 MES ≤ 1 and Geboes highest grade <3.2. Secondary outcomes included endoscopic remission (ER) (MES = 0), histologic improvement (Geboes highest grade <3.2), and clinical remission (CR) (total Mayo score ≤2 and no subscore >1). Histologically active disease was defined as Geboes highest grade >3.2 (>50% of neutrophil crypt involvement in the epithelium). RESULTS: Week 52 outcomes were similar 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: Patients with histologically active MES 1 had comparable clinical and histologic outcomes at week 52 as those with conventional mild-moderate UC, suggesting that histology may better predict prognosis than symptoms or endoscopy alone.
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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 | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".