{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:23:12Z","timestamp":1788600192710,"version":"build-2803163510"},"reference-count":21,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T00:00:00Z","timestamp":1673827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ferring Pharmaceuticals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: At present, there is no consensus definition of mild-to-moderate disease activity in patients with ulcerative colitis. The objective of the present study was to establish a reliable definition of mild-to-moderate disease activity in adult patients with ulcerative colitis. Materials and Methods: Twelve physicians from around the world participated in a virtual consensus meeting on 26 September 2022. All the physicians had expertise in the diagnosis and treatment of inflammatory bowel disease. After a systematic review of the literature and expert opinion, a modified version of the RAND\/University of California, Los Angeles appropriateness method was applied. A total of 49 statements were identified and then anonymously rated (on a 9-point scale) as being appropriate (scores of 7 to 9), uncertain (4 to 6) or inappropriate (1 to 3). The survey results were reviewed and amended before a second round of voting. Results: Symptom and endoscopic-based measurements are of prime importance for assessing mild-to-moderate ulcerative colitis activity in clinical trials. The experts considered that clinical activity should be assessed in terms of stool frequency, rectal bleeding and fecal urgency, whereas endoscopic activity should be evaluated with regard to the vascular pattern, bleeding, erosions and ulcers. Fecal calprotectin was considered to be a suitable disease activity marker in mild-to-moderate ulcerative colitis. Lastly, mild-to-moderate ulcerative colitis should not have more than a small impact on the patient\u2019s daily activities. Conclusions: The present recommendations constitute a standardized framework for defining mild-to-moderate disease activity in clinical trials in the field of ulcerative colitis.<\/jats:p>","DOI":"10.3390\/medicina59010183","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T06:52:10Z","timestamp":1673851930000},"page":"183","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["International Consensus on Definition of Mild-to-Moderate Ulcerative Colitis Disease Activity in Adult Patients"],"prefix":"10.3390","volume":"59","author":[{"given":"B\u00e9n\u00e9dicte","family":"Caron","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Inserm NGERE U1256, Nancy University Hospital, University of Lorraine, 54500 Vandoeuvre-l\u00e8s-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vipul","family":"Jairath","sequence":"additional","affiliation":[{"name":"Department of Medicine, Western University, London, ON N6A 3K7, Canada"},{"name":"Department of Epidemiology and Biostatistics, Western University, London, ON N6A 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinando","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, 20132 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Al Awadhi","sequence":"additional","affiliation":[{"name":"Gastroenterology Division, Rashid Hospital, Dubai Health Authority, Dubai 003206, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9724-054X","authenticated-orcid":false,"given":"Axel","family":"Dignass","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Agaplesion Markus Hospital, Goethe-University, 60431 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailsa L.","family":"Hart","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Unit, St. Mark\u2019s Hospital, Harrow HA1 3UJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo 108-8642, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9632-6691","authenticated-orcid":false,"given":"Paulo Gustavo","family":"Kotze","sequence":"additional","affiliation":[{"name":"IBD Outpatient Clinics, Colorectal Surgery Unit, Pontificia Universidade Cat\u00f3lica do Paran\u00e1 (PUCPR), Curitiba 80215-901, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2634-9668","authenticated-orcid":false,"given":"Fernando","family":"Magro","sequence":"additional","affiliation":[{"name":"Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200319 Porto, Portugal"},{"name":"Department of Clinical Pharmacology, S\u00e3o Jo\u00e3o University Hospital Center (CHUSJ), 4200319 Porto, Portugal"},{"name":"Center for Health Technology and Services Research (CINTESIS), 4200319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0055-958X","authenticated-orcid":false,"given":"Britta","family":"Siegmund","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany"},{"name":"Department of Gastroenterology, Rheumatology and Infectious Disease, Campus Benjamin Franklin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Paridaens","sequence":"additional","affiliation":[{"name":"Ferring International Center S.A. 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De la Vergognausaz 50, 1162 Saint-Prex, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7341-1351","authenticated-orcid":false,"given":"Silvio","family":"Danese","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Peyrin-Biroulet","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Inserm NGERE U1256, Nancy University Hospital, University of Lorraine, 54500 Vandoeuvre-l\u00e8s-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1053\/j.gastro.2018.12.009","article-title":"AGA Clinical Practice Guidelines on the Management of Mild-to-Moderate Ulcerative Colitis","volume":"156","author":"Ko","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1038\/nrgastro.2016.128","article-title":"Current best practice for disease activity assessment in IBD","volume":"13","author":"Walsh","year":"2016","journal-title":"Nat. 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