Linking histological healing to quality of life: real-world insights into golimumab therapy in ulcerative colitis.

Abstract

Background: Ulcerative colitis (UC) significantly impacts patients' quality of life (QoL). Therapeutic strategies have increasingly focused on achieving histological and endoscopic remission in addition to clinical outcomes and patient-reported measures. Real-world data on the effectiveness of golimumab to achieve histologic remission is scarce.

Methods: This was a multicenter, cohort study including 73 patients with moderate-to-severe UC treated with golimumab across Brazilian centers. Outcomes were assessed at weeks 24 and 54 and included histological remission (Nancy histological index [NHI]), endoscopic remission (Mayo endoscopic subscore [MES]), inflammatory biomarkers (CRP and fecal calprotectin), and QoL (IBDQ-36). Correlations between histological scores with endoscopic outcomes and QoL were analyzed using Spearman test.

Results: At week 24, 32.4% of patients achieved complete histological remission (NHI grade 0), and 80.8% achieved endoscopic remission (MES 0 or 1). At week 54, 55.2% of patients had histological remission and 84.4% of patients achieved endoscopic remission. Mean CRP levels decreased from 13.16 mg/dL at baseline to 1.35 mg/dL at week 54 (p < 0.001), and mean calprotectin decreased from 2113.2 to 106.9 mcg/g (p < 0.001). QoL significantly improved, with IBDQ-36 scores increasing from 121.5 at baseline to 182.1 at week 24 and 194.2 at week 54 (p = 0.002). Significant correlations were observed between NHI with MES and IBDQ-36 at week 24.

Conclusion: Golimumab has achieved sustained efficacy in the induction of histological and endoscopic remission and improvement in QoL in patients with moderate-to-severe UC in a real-world setting. These results support the use of golimumab as an effective, patient-centered therapeutic option, particularly when multidimensional disease control is the goal.