Original ArticleAlimentary TractHistologic Features of Colon Biopsies (Geboes Score) Associated With Progression of Ulcerative Colitis for the First 36 Months After Biopsy
Section snippets
Study Design and Participants
This study was based on a convenience sample of asymptomatic UC patients who were previously enrolled in the prospective study ACERTIVE.19 All patients signed an informed consent form before their inclusion in the study.19
Patients were followed in 13 inflammatory bowel disease centers in Portugal until December 31, 2019. Patients were prospectively followed during the study period, without establishing fixed periods for the follow-up.
Patients who met the following criteria were included: older
Demographic and Clinical Characteristics
The description of the cohort of UC patients is presented in Table 1. This cohort consisted of 399 asymptomatic patients with a median age of 53 years (44–65), and 53% were female.
Progressive disease occurred in 31% of patients during the study period. The prescription or use of at least one course of oral corticosteroids (14%), de novo azathioprine (10%), de novo anti-TNFα (9%), and increase in the dose of azathioprine or biologics (9%) were the most frequent events of the composite outcome.
Discussion
In this study we have shown that histologic activity (GS >2B.0, GS >3.0, or GS>4.0) is an independent risk factor for the occurrence of progressive disease in asymptomatic UC patients in the first 36 months from biopsy but not after this period, suggesting that the value of histologic assessment is time-limited. Most of the published studies have determined the cutoff values of histologic activity that are associated with worse outcomes in UC patients.6,10,12,21 In this study, besides showing
Acknowledgments
The authors thank GEDII and all investigators at the hospitals who provided data for the study and Sandra Dias for all her assistance during data collection. MS acknowledges “Fundação para a Ciência e Tecnologia (FCT)”, Portugal under grant number PD/BD/142890/2018.
CRediT Authorship Contributions
Fernando Magro, MD, PhD (Conceptualization: Lead; Funding acquisition: Lead; Investigation: Supporting; Methodology: Equal; Validation: Lead; Writing – review & editing: Lead)
Catarina Alves (Data curation: Lead; Investigation: Lead;
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Conflicts of interest This author discloses the following: FM received a fee for presenting from AbbVie, Ferring, Falk, Hospira, PharmaKern, MSD, Schering, Laboratórios Vitoria, Vifor Pharma, and OM Pharma. The remaining authors disclose no conflicts.
Funding Supported by the Portuguese Group of Studies in Inflammatory Bowel Disease (GEDII).
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Authors share co-first authorship.