Treatment endpoints in ulcerative colitis: Does one size fit all?

Table 1 Mean times (in weeks) for various induction therapies to reach a particular endpoint in ulcerative colitis

Therapy	Treatment endpoints
	Clinical response	Clinical remission	Normalisation CRP/ESR	Decrease of faecal calprotectin	Mucosal healing
Oral 5-aminosalicylates	4	8	8	10	13
Oral steroids	2	2	5	8	11
Locally acting steroids	3	8	8	9	13
Thiopurines	11	15	15	15	20
Adalimumab	6	11	10	12	14
Infliximab	5	10	9	11	13
Vedolizumab	9	14	14	15	18
Tofacitinib	6	11	9	11	14

CRP: C reactive protein; ESR: Erythrocyte sedimentation rate. Adapted from Turner et al[4], 2021.

Table 2 Suggested table for documentation of treatment endpoints in ulcerative colitis

Time frame	Short term		Medium term		Long term
Proposed duration	6-8 wk		12-16 wk		26-52 wk
Endpoint type	Minimum endpoints	Ideal endpoints	Minimum endpoints	Ideal endpoints	Minimum endpoints	Ideal endpoints
Endpoints	Clinical response; Biochemical response; IUS response	Clinical remission; Biochemical remission; IUS remission	Clinical remission; IUS response; Endoscopic response	IUS remission; Endoscopic remission	Endoscopic remission; Histologic response	Endoscopic healing; Histologic healing; Gut barrier function restoration

It is recommended that endpoints in this table are re-evaluated periodically to either confirm or modify endpoints depending on individual patient factors. The above may be applicable for an otherwise healthy adult with ulcerative colitis. Ideal endpoints are in addition to minimum endpoints. IUS: Intestinal ultrasound.