{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T20:54:55Z","timestamp":1765486495205,"version":"3.37.3"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T00:00:00Z","timestamp":1599523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Portuguese Group of Studies in Inflammatory Bowel Disease"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>Interest in histology for ulcerative colitis [UC] has increased recently. This systematic review and meta-analysis aims to assess, for the first time, whether histological outcomes are more informative than endoscopic and clinical outcomes in distinguishing the impact of intervention over placebo in induction trials.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>MEDLINE, ScienceDirect and Cochrane Central Register of Controlled Trials were searched to identify randomized placebo-controlled trials [RCTs] enrolling moderate-to-severe UC patients. Studies were assessed using the Quality Assessment Tool for Studies with Diverse Designs. We analysed the pooled proportion of patients achieving clinical, endoscopic and histological remission and response after a pharmacological intervention and compared the results with those of placebo-treated patients by using a random-effects model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 889 identified records, 13 RCTs were included. The odds ratio [OR] for remission was higher in patients receiving intervention than in those under placebo for clinical (OR 2.13, 95% confidence interval [CI] 1.33\u20133.43), endoscopic [OR 1.46, 95% CI 0.19\u201311.18] and histological remission [OR 1.85, 95% CI 1.20\u20132.84]. Significant differences were observed for all response outcomes [clinical: OR 2.27, 95% CI 1.84\u20132.85; endoscopic: OR 2.16, 95% CI 1.51\u20133.10; histological: OR 3.63, 95% CI, 1.41\u20139.36]. No significant heterogeneity existed; no subgroup effects were found for duration of the induction or histological scale [p\u2005&amp;gt;\u20050.05]. Clinical and histological remission and endoscopic response were concordant in discriminating interventions from placebo.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Histological outcomes are informative in trials of moderate-to-severe UC. Further studies analysing histology at the end of induction are needed to confirm its relevance in distinguishing the efficacy of an intervention over placebo in comparison to clinical and endoscopic outcomes and to explore its prognostic value.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaa176","type":"journal-article","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T11:11:29Z","timestamp":1599131489000},"page":"551-566","source":"Crossref","is-referenced-by-count":13,"title":["Clinical, Endoscopic and Histological Outcomes in Induction of Moderate-to-Severe Ulcerative Colitis: A Systematic Review with Meta-Analysis"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2634-9668","authenticated-orcid":false,"given":"Fernando","family":"Magro","sequence":"first","affiliation":[{"name":"Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o Hospital Center, Porto, Portugal"},{"name":"MedInUP, Center for Drug Discovery and Innovative Medicines, Porto, Portugal"},{"name":"Clinical Pharmacology Unit, S\u00e3o Jo\u00e3o Hospital University Center, Porto, Portugal"}]},{"given":"Maria Manuela","family":"Estevinho","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Department of Gastroenterology, Vila Nova de Gaia\/Espinho Hospital Center, Vila Nova de Gaia, Portugal"}]},{"given":"Cl\u00e1udia Camila","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Decision in Health, Faculty of Medicine of the University of Porto, Porto, Portugal"},{"name":"Centre for Health Technology and Services Research, Porto, Portugal"}]},{"given":"Lu\u00eds","family":"Correia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal"}]},{"given":"Paula","family":"Lago","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Porto Hospital Center, Porto, Portugal"}]},{"given":"Paula","family":"Ministro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tondela-Viseu Hospital Center, Viseu, Portugal"}]},{"given":"Francisco","family":"Portela","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital Center of Coimbra, Coimbra, Portugal"}]},{"given":"Roger","family":"Feakins","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Royal Free London NHS Foundation Trust, London, UK"}]},{"given":"Silvio","family":"Danese","sequence":"additional","affiliation":[{"name":"IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center- IRCCS-, Rozzano, Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"}]},{"given":"Laurent","family":"Peyrin-Biroulet","sequence":"additional","affiliation":[{"name":"Institut National de la Sante\u0301 et de la Recherche Me\u0301dicale U954 and Department of Gastroenterology, Nancy University Hospital, Lorraine University, Nancy, France"}]}],"member":"286","published-online":{"date-parts":[[2020,9,8]]},"reference":[{"key":"2021040705214449100_CIT0001","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1177\/2050640617752207","article-title":"Prognostic value of histological activity in patients with ulcerative colitis in deep remission: A prospective multicenter study","volume":"6","author":"Lobat\u00f3n","year":"2018","journal-title":"United Eur Gastroenterol 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