Histologic Remission in Ulcerative Colitis: Are We There Yet?

As the field of inflammatory bowel disease moves toward treating to a "target" that includes mucosal healing, better outcome definitions are needed. One important question is whether the definition of mucosal healing should include "histologic" remission. In this systematic review and meta-analysis, the authors describe histologic healing rates of medical therapies for ulcerative colitis in randomized controlled trials. Although observational data demonstrate that histologic remission has consistently been associated with improved outcomes, we argue that there is a great deal of work left to be done before we can embrace a histologic endpoint of management in ulcerative colitis.