P1225Disease Clearance and Clinical Outcomes in Patients with Ulcerative Colitis

Abstract Background Ulcerative colitis (UC) is a chronic, incurable, and clinically heterogeneous disease. The concept of disease clearance has recently emerged as an ideal therapeutic target, defined by the simultaneous achievement of clinical, endoscopic, and histologic remission. This comprehensive goal has been associated with improved long-term outcomes, including a lower risk of hospitalization and disease progression. However, the real-world frequency of disease clearance and its associated clinical factors remain largely unknown worldwide. This study aimed to determine the frequency of disease clearance and its associated clinical outcomes in patients with UC. Methods A cross-sectional study was conducted, including 100 patients with a confirmed diagnosis of UC from the Inflammatory Bowel Disease Clinic at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in the period between January and May 2025. Disease clearance was defined as the coexistence of clinical, endoscopic, and histologic remission. Disease activity and remission were assessed using the Integral UC Index (Yamamoto-Furusho Index), which includes clinical, biochemical, endoscopic, and histologic parameters. Results A total of 100 patients were included (57 women and 43 men), with a mean age of 50 years (range: 22–83) and a median disease duration of 15 years (range: 2–42). The overall frequency of disease clearance was 37%. Extensive colitis (E3) was the most frequent disease extent (76%), followed by left-sided colitis (E2, 16%) and proctitis (E1, 8%). Among all patients, 80% achieved clinical remission according to the partial Mayo score, 50% achieved endoscopic remission, and 45% achieved histologic remission based on the Nancy index. In the bivariate analysis, lack of disease clearance was significantly associated with a higher number of hospitalizations (P = 0.02, OR = 3.0, 95% CI: 1.11–8.47). Multivariate logistic regression confirmed that patients without disease clearance were more likely to experience ≥2 hospitalizations (OR = 5.41, 95% CI: 1.44–20.28; P = 0.01). The table summarizes medical therapies used among patients who achieved disease clearance. Other variables, such as age at diagnosis, disease extent, treatment type showed no statistically significant association. Conclusion Disease clearance was achieved in 37% of patients with UC. The absence of disease clearance was independently associated with multiple hospitalizations due to disease relapse. These findings highlight the relevance of achieving disease clearance. References: D’Amico F, Magro F, Siegmund B, Kobayashi T, et al. Disease clearance as a new outcome in ulcerative colitis: a systematic review and expert consensus. Inflamm Bowel Dis. 2024;30(6):1009-1017. Ramos L, Teo-Loy J, Barreiro-de Acosta M. Disease clearance in ulcerative colitis: setting the therapeutic goals for future in the treatment of ulcerative colitis. Front Med (Lausanne). 2023;9:1102420. D’Amico F, Peyrin-Biroulet L, Danese S. Disease clearance in ulcerative colitis: is the ultimate therapeutic target? United European Gastroenterol J. 2023;11(8):717-719. Conflict of interest: Dr. Parra Holguín, Norma Nathaly: No conflict of interest Gutiérrez Herrera, Fausto Damian: No conflict of interest Juárez Cruz, Samuel Ismael: No conflict of interest Yamamoto-Furusho, Jesús Kazuo: No conflict of interest