Four histological disease-activity indices similarly reliable in ulcerative colitis

Last Updated: 2018-08-17

By Reuters Staff

NEW YORK (Reuters Health) - The four commonly used histological disease-activity indices appear similarly reliable in patients with ulcerative colitis (UC), based on a post hoc analysis of data from the TOUCHSTONE trial.

Several incompletely validated indices are currently used, including the Geboes Score (GS), the modified Riley score (MRS), the Robarts Histopathology Index (RHI) and the Nancy Histological Index (NHI).

Dr. Vipul Jairath from Robarts Clinical Trials Inc. and the University of Western Ontario, in London, Canada, and colleagues used data from 197 patients with moderately to severely active UC who participated in a randomized clinical trial of ozanimod (an investigational immunomodulatory drug) to assess the reliability and responsiveness to change after a therapeutic intervention of all four indices, as well as a visual analog scale (VAS).

Both intra-rater and inter-rater reliability were considered substantial to almost perfect for all four histological indices, the team reports in Gut, online August 3.

Changes in the histopathology scores over time correlated highly with each other and the VAS, but correlations with the total Mayo Clinic score and its component scores (including endoscopy) were considerably lower (<0.45).

Based on data from the ozanimod trial, all four indices were capable of correctly discriminating between patients in the treatment group and those in the placebo group, and AUC receiver operating characteristic (ROC) estimates confirmed similar responsiveness among the indices.

"These results collectively suggest that, based on the analysis of this single dataset, any of the four existing histological indices could reliably be used for measurement of disease activity, as well as for evaluating response to treatment in a similar population of patients with UC," the researchers conclude. "Selection of the preferred histological index is likely to be dictated by training, feasibility, and preference."

"Further validation in other datasets is essential to determine the relative responsiveness of the indices and the most appropriate index for use in particular populations of patients," they add.

Dr. Jairath did not respond to a request for comments.

SOURCE: https://bit.ly/2vS5inT

Gut 2018.