{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:26:30Z","timestamp":1773411990370,"version":"3.50.1"},"reference-count":88,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T00:00:00Z","timestamp":1695427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>In inflammatory bowel disease (IBD), mucosal healing is the primary long-term treatment goal, encompassing both endoscopic and histological outcomes. This paper aims to overview the ability of new treatment options to promote endoscopic and histological healing and to discuss the prognostic significance of endoscopic and histological outcomes. The analysis included randomized-controlled trials (published since 2020) focused on the impact of pharmacological interventions on endoscopic and histological remission in IBD. Even though the Mayo endoscopic subscore is routinely used, the application of validated scoring systems for ulcerative colitis is uncommon. In Crohn\u2019s disease (CD), the application of endoscopic scores remains limited to clinical studies. The standardized evaluation of histological features has been performed in several recent ulcerative colitis trials, resorting mostly to the Geboes score and the Nancy histological index. Still, the use of histological scores for CD remains elusive. Current evidence underscores that histological remission conveys the best long-term prognosis, supporting the inclusion of histology as a treatment guide in ulcerative colitis. In CD, data are promising but originated from a few retrospective studies. Further efforts are warranted to: (1) use validated histological indexes for ulcerative colitis, aiming their adoption as treatment targets; (2) promote the validation and utilization of histological scores for CD, at least in clinical studies; (3) confirm the prognostic impact of histological remission in CD; (4) integrate artificial intelligence assets to support grading, particularly in the setting of histology; (5) prospectively define the monitoring frequency of IBD patients who achieved histological remission.<\/jats:p>","DOI":"10.1093\/jcag\/gwad034","type":"journal-article","created":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T03:51:27Z","timestamp":1695527487000},"page":"46-58","source":"Crossref","is-referenced-by-count":8,"title":["Managing Ulcerative Colitis and Crohn\u2019s Disease: Should the Target Be Endoscopy, Histology, or Both?"],"prefix":"10.1093","volume":"7","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":"CINTESIS@RISE, Department of Biomedicine, Faculty of Medicine of the University of Porto , Porto , Portugal"},{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o Hospital Center , Porto , Portugal"},{"name":"Clinical Pharmacology Unit, S\u00e3o Jo\u00e3o Hospital University Center , Porto , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7171-0139","authenticated-orcid":false,"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 , Porto , Portugal"}]},{"given":"Andr\u00e9","family":"Valois","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Unit, S\u00e3o Jo\u00e3o Hospital University Center , Porto , Portugal"}]}],"member":"286","published-online":{"date-parts":[[2023,9,23]]},"reference":[{"key":"2024020222244014600_CIT0001","first-page":"357","article-title":"\u201cNew Targets in Inflammatory Bowel Disease Therapy: 2021.\u201d","volume-title":"Current Opinion in Gastroenterology","author":"Cohen","year":"2021"},{"key":"2024020222244014600_CIT0002","first-page":"1619","article-title":"\u201cMucosal Healing in Inflammatory Bowel Diseases: A Systematic Review.\u201d","volume-title":"Gut","author":"Neurath","year":"2012"},{"key":"2024020222244014600_CIT0003","first-page":"939","article-title":"\u201cHistological Scores in Patients with Inflammatory Bowel Diseases: The State of the Art.\u201d","volume-title":"Journal of Clinical 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IBD.\u201d","volume-title":"Gastroenterology","author":"Turner","year":"2021"},{"key":"2024020222244014600_CIT0007","first-page":"2510","article-title":"\u201cComplete Resolution of Mucosal Neutrophils Associates With Improved Long-Term Clinical Outcomes of Patients With Ulcerative Colitis.\u201d","volume-title":"Clinical Gastroenterology and Hepatology","author":"Pai","year":"2020"},{"key":"2024020222244014600_CIT0008","first-page":"551","article-title":"\u201cClinical, Endoscopic and Histological Outcomes in Induction of Moderate-to-Severe Ulcerative Colitis: A Systematic Review with Meta-Analysis.\u201d","volume-title":"Journal of Crohn's and Colitis","author":"Magro","year":"2021"},{"key":"2024020222244014600_CIT0009","first-page":"1692","article-title":"\u201cHistological Disease Activity as a Predictor of Clinical Relapse Among Patients With Ulcerative Colitis: Systematic Review and Meta-Analysis.\u201d","volume-title":"American Journal of Gastroenterology","author":"Park","year":"2016"},{"key":"2024020222244014600_CIT0010","first-page":"1503","article-title":"\u201cECCO Position Paper: Harmonization of the Approach to Ulcerative Colitis Histopathology.\u201d","volume-title":"Journal of Crohn's and Colitis","author":"Magro","year":"2020"},{"key":"2024020222244014600_CIT0011","first-page":"2291","article-title":"\u201cAn International Consensus to Standardize Integration of Histopathology in Ulcerative Colitis Clinical Trials.\u201d","volume-title":"Gastroenterology","author":"Ma","year":"2021"},{"key":"2024020222244014600_CIT0012","first-page":"1407","article-title":"\u201cHistological Outcomes and Predictive Value of Faecal Markers in Moderately to Severely Active Ulcerative Colitis Patients Receiving Infliximab.\u201d","volume-title":"Journal of Crohn's and Colitis","author":"Magro","year":"2016"},{"key":"2024020222244014600_CIT0013","first-page":"731","article-title":"\u201cAdalimumab for Induction of Histological 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Prospective Study of Electronic Chromoendoscopy Score PICaSSO in Ulcerative Colitis.\u201d","volume-title":"Gastroenterology","author":"Iacucci","year":"2021"},{"key":"2024020222244014600_CIT0037","first-page":"2123","article-title":"\u201cEfficacy and Safety of Upadacitinib in a Randomized Trial of Patients with Crohn\u2019s Disease.\u201d","volume-title":"Gastroenterology","author":"Sandborn","year":"2020"},{"key":"2024020222244014600_CIT0038","first-page":"2015","article-title":"\u201cRisankizumab as Induction Therapy for Crohn\u2019s Disease: Results from the Phase 3 Advance and Motivate Induction Trials.\u201d","volume-title":"Lancet","author":"D\u2019Haens","year":"2022"},{"key":"2024020222244014600_CIT0039","first-page":"2031","article-title":"\u201cRisankizumab as Maintenance Therapy for Moderately to Severely Active Crohn\u2019s Disease: Results from the Multicentre, Randomised, Double-Blind, Placebo-Controlled, Withdrawal Phase 3 Fortify Maintenance 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