Mucosal healing (MH) is a novel treatment target in patients with ulcerative colitis (UC) and is associated with improved long-term outcomes. Researchers performed a meta-analysis to compare outcomes of Mayo endoscopic score (MES) 0 or 1 to identify the optimal treatment target. According to the article, published in BMC Gastroenterology, MES 0 was associated with a lower rate of clinical relapse than MES 1, concluding that MES 0 should be considered a therapeutic target for those with UC rather than MES 0-1.
The analysis included 15 studies from the Medline, Scopus, and CENTRAL databases. The population of interest had UC and were in steroid-free clinical remission, had a MES score of 0 or 1, and had at least 12 months of available follow-up data.
In the study, investigators observed an increase in clinical relapse in patients with MES 1 in all of the included studies, “suggesting that MES of 1 have a higher risk of relapse than a score of 0.” Additionally, MES 0 patients had a lower risk of clinical relapse (odds ratio = 0.33; 95% confidence interval, 0.26–0.43; I2 = 13%) regardless of follow-up length. However, the authors noted that there were no noticeable differences when comparing MES 0 vs MES 1 regarding risk of hospitalization or colectomy.
Though the researchers acknowledged limitations, including different definitions of clinical relapse among included studies, they ultimately advised that “MES 0 should therefore be considered the optimal therapeutic goal as it predicts the best clinical course in patients with UC.”