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In a recent article1 we showed that correlation between histological indexes is strong for ulcerative colitis (UC). Due to the lack of intervention studies and the absence of a validated histological index, histological healing cannot be considered as a treatment goal in clinical practice for these patients. Pending these studies, we need to define the therapeutic goal for patients with UC.
In the ACT 1 and 2 clinical trials,2 early mucosal healing defined by an endoscopic Mayo score (EMS) of 0–1 was associated with a lower risk of colectomy through 54 weeks of follow-up evaluation and better long-term outcomes related to symptomatic remission, corticosteroid-free symptomatic remission and corticosteroid use, and subsequent mucosal healing at weeks 30 and 54. With the exception of colectomy …