Table 2.
Studies investigating the rate of achieving mucosal healing with use of serial endoscopy.
| Study, Year, Design | Population (No., UC/CD), Follow-Up |
Presence of Baseline Endoscopic Activity (No., %) | No. of Endoscopic Assessments, No. (%) pts Undergoing | No. of Therapy Adjustments Made | Definition of MH, Definition of ER, No. (%) Achievement | Associations |
|---|---|---|---|---|---|---|
| Bouguen et al., 2014, retrospective observational study [34] | 60 pts, 100% UC, median follow-up 76 weeks |
45 (75%) | 2: 26 (43%) 3: 26 (43%) 4: 8 (13%) Median interval between consecutive endoscopies 25 weeks (IQR, 16–42 weeks) |
51 adjustments made within the 45 pts with endoscopic disease activity | MH: MES = 0. MH: 27 (60%) pts with baseline endoscopic disease activity |
MH associated with: Post-endoscopy adjustments in medical therapy made in the case of persistent endoscopic activity (HR 9.8, 95% CI 3.6–34.5; p < 0.0001). |
| Bouguen et al., 2014, retrospective observational study [35] | 67 pts, 100% CD, median follow-up 62 weeks |
67 (100%) | 2: 40 (60%) 3: 21 (31%) 4: 6 (9%) Median interval between consecutive endoscopies 24 weeks (IQR, 17–38 weeks) |
72 adjustments made as a result of endoscopic findings of ulceration | MH: absence of any ulcers in GIT. ER: downgrading of deep ulcers to superficial ulcers or the disappearance of superficial ulcers. MH: 34 (50.7%) pts, ER: 41 (61.1%) pts |
MH associated with: <26 weeks between endoscopic procedures (HR 2.35; p= 0.035), adjustment to medical therapy when MH was not observed (HR 4.28; p = 0.0003). |
| Meade et al., 2023, retrospective observational study [36] | 50 pts, 100% CD | 50 (100%) | 2: 50 (100%) Interval between endoscopies not stated |
0 | MH: SES-CD ≤ 2 ER: >50% reduction in SES-CD MH: 25 (50%) ER: 35 (70%) |
Treatment failure associated with: Failure to achieve MH (HR 11.62, 95% CI 3.33–40.56; p = 0.003), failure to achieve ER (HR 30.30, 95% CI 6.93–132.30; p < 0.0001). |
| Mao et al., 2017, retrospective observational study [37] | 272 pts, 100% CD Median follow-up 33 months (IQR 27–38 months). |
272 (100%) | 2: 272 (100%) 3: 154 (56.6%) 4: 69 (25.3%) 5: 26 (9.6%) 6: 10 (3.6%) 7: 4 (1.5%) Median interval between consecutive endoscopy 24 weeks (IQR: 17–38 weeks). |
237 adjustments made as a result of endoscopic findings of ulceration | MH: mucosal activity score of 0–2 MH: 126 (46.3%) endoscopic score system adopted from Af Björkesten et al. [38], mucosal activity scored from in most affected area. |
MH associated with: <26 weeks between endoscopic procedures (HR 1.56; 95% CI 1.05–3.39; p = 0.03), adjustment of medical therapy when MH was not achieved (HR 2.07; 95% CI 1.26–2.33; p < 0.01), CRP normalisation within 12 weeks (HR 3.23; 95% CI 1.82–5.88; p < 0.01). |
| Wetwittayakhlang et al., 2022, prospective, observational study [39] |
104 pts, 82 (79%) CD, 22 (21%) UC, consecutively recruited |
70.6% CD 81.3% UC |
2 (relative proportions of study population not stated) | Not stated | MH: not stated MH at 6 months: 46.2% of CD pts with baseline endoscopic activity. 25% of UC pts with baseline activity MH at 12 months: 44.4% of CD pts with baseline endoscopic activity. 33% of UC pts with baseline activity |
Not stated |
CD, Crohn’s disease; CI, confidence interval; ER, endoscopic response; GIT, gastrointestinal tract; HR, hazard ratio; IQR, interquartile range; MES, Mayo endoscopic sub score; MH, mucosal healing; No., number; Pts, patients; SES-CD, simple endoscopic score for Crohn’s disease; UC, ulcerative colitis.