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Review
. 2025 Jul;13(6):902-910.
doi: 10.1002/ueg2.12714. Epub 2025 Apr 16.

Disease Clearance in Ulcerative Colitis: A Narrative Review

Silvio Danese  1 , Laurent Peyrin-Biroulet  2 , Vipul Jairath  3   4 , Ferdinando D'Amico  1 , Shashi Adsul  5 , Christian Agboton  5 , Fernando Magro  6
Affiliations
Review

Disease Clearance in Ulcerative Colitis: A Narrative Review

Silvio Danese et al. United European Gastroenterol J. 2025 Jul.

Abstract

Ulcerative colitis (UC) is a chronic relapsing disease with significant associated risks such as colectomy, hospitalization, or colorectal cancer. A treat-to-target approach that mitigates disease activity and progression from an early stage is needed. The latest STRIDE II guidelines advocate for clinical and endoscopic remission as the main therapeutic targets in the management of UC; however, histological remission is increasingly being recognized as an important outcome. The concept of disease clearance, a composite outcome comprising clinical, endoscopic, and histological remission, has been proposed as a potential target for patients with UC and has been precisely defined by the International Organization for the Study of Inflammatory Bowel Disease, with the aim of standardizing its use in clinical practice and research. Despite challenges, including variable standardized definitions and uncertainties regarding the timing of reaching different definitions of remission, disease clearance corresponds to comprehensive disease control, and its use as an outcome could help clinicians to better evaluate the actual status of the disease. Furthermore, achieving disease clearance may be related to an improved disease course, positive long-term outcomes, and an improvement in health-related quality of life. Real-world evidence supports the feasibility of achieving disease clearance with various treatment modalities, including vedolizumab, the only gut-selective antilymphocyte trafficking drug. The aim of this narrative review is to explore the concept of disease clearance in patients with disease clearance, mainly focusing on trials evaluating vedolizumab but also other biologics.

Keywords: STRIDE; course; disease modification; histological healing; mucosal healing; progression; remission; target; therapy; vedolizumab.

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Conflict of interest statement

Silvio Danese reports receiving lecture fees from and serving as a consultant for AbbVie, Allergan, Biogen, Boehringer Ingelheim, Celgene, Celltrion, Ferring, Hospira, Johnson & Johnson, Merck, Merck Sharp & Dohme, Mundipharma, Pfizer, Sandoz, Takeda, TiGenix, UCB, and Vifor. Laurent Peyrin‐Biroulet reports receiving consulting fees from AbbVie, Abivax, Adacyte, Alimentiv, Amgen, Applied Molecular Transport, Arena, Banook, Biogen, Bristol Myers Squibb, Celltrion, Connect Biopharm, Cytoki Pharma, Enthera, Ferring, Fresenius Kabi, Galapagos, Genentech, Gilead, GlaxoSmithKline, Gossamer Bio, IAC Image Analysis, Index Pharmaceuticals, Inotrem, Janssen, Medac, Mopac, Morphic, Merck Sharp & Dohme, Nordic Pharma, Novartis, Oncodesign Precision Medicine, ONO Pharma, OSE Immunotherapeuthics, Pandion Therapeutics, Par' Immune, Pfizer, Prometheus, Protagonist, Roche, Samsung, Sandoz, Sanofi, Satisfay, Takeda, Telavant, Theravance, Thermo Fischer, TiGenix, Tillots, Vectivbio, Ventyx, Viatris, and Ysopia; grants from Celltrion, Fresenius Kabi, Medac, Merck Sharp & Dohme, and Takeda; and lecture fees from AbbVie, Amgen, Arena, Biogen, Celltrion, Eli Lilly and Company, Ferring, Galapagos, Genentech, Gilead, Janssen, Medac, Merck Sharp & Dohme, Nordic Pharma, Pfizer, Sandoz, Takeda, Tillots, and Viatris. Vipul Jairath reports receiving consulting/advisory board fees from AbbVie, Alimentiv, Arena, Asahi Kasei Pharma, Asieris, AstraZeneca, Bristol Myers Squibb, Celltrion, Eli Lilly and Company, Ferring, Flagship Pioneering, Fresenius Kabi, Galapagos, Genentech, Gilead, GlaxoSmithKline, Janssen, Merck, Mylan, Pandion, Pendopharm, Pfizer, Protagonist, Reistone Biopharma, Roche, Sandoz, Second Genome, Takeda, Teva, Topivert, Ventyx, and Vividion; and speaker fees from AbbVie, Ferring, Fresenius Kabi, Galapagos, Janssen, Pfizer, Shire, and Takeda. Ferdinando D'Amico serves as a speaker for Galapagos, Janssen, Omega Pharma, Sandoz, and Takeda and as an advisory board member for AbbVie, Ferring, Galapagos, Janssen, and Nestlé. Fernando Magro has served as a speaker for AbbVie, Arena, Biogen, Bristol Myers Squibb, Eli Lilly and Company, Falk, Ferring, Hospira, Janssen, Laboratórios Vitoria, Merck Sharp & Dohme, Pfizer, Sandoz, Takeda, UCB, and Vifor. Shashi Adsul and Christian Agboton are employees of and hold stock/stock options in Takeda.

Figures

FIGURE 1
FIGURE 1
Disease clearance in ulcerative colitis. CRP, C‐reactive protein.
See this image and copyright information in PMC

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References

    1. Ungaro R., Mehandru S., Allen P. B., Peyrin‐Biroulet L., and Colombel J. F., “Ulcerative Colitis,” Lancet 389, no. 10080 (2017): 1756–1770, 10.1016/S0140-6736(16)32126-2. - DOI - PMC - PubMed
    1. Dal Buono A., Roda G., Argollo M., Zacharopoulou E., Peyrin‐Biroulet L., and Danese S., “Treat to Target or ‘Treat to Clear’ in Inflammatory Bowel Diseases: One Step Further?,” Expert Review of Gastroenterology & Hepatology 14, no. 9 (2020): 807–817, 10.1080/17474124.2020.1804361. - DOI - PubMed
    1. Park J. M., Kim J., Lee Y. J., Bae S. U., and Lee H. W., “Inflammatory Bowel Disease‐Associated Intestinal Fibrosis,” Journal of pathology and Translational Medicine 57, no. 1 (2023): 60–66, 10.4132/jptm.2022.11.02. - DOI - PMC - PubMed
    1. Tavares de Sousa H. and Magro F., “How to Evaluate Fibrosis in IBD?,” Diagnostics 13, no. 13 (2023): 2188, 10.3390/diagnostics13132188. - DOI - PMC - PubMed
    1. Turner D., Ricciuto A., Lewis A., et al., “STRIDE‐II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat‐to‐Target Strategies in IBD,” Gastroenterology 160, no. 5 (2021): 1570–1583, 10.1053/j.gastro.2020.12.031. - DOI - PubMed

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