Frequency and Analysis of Deep Remission in Patients With Ulcerative Colitis: A Single-Center Retrospective Study

Background:
Ulcerative colitis (UC) is an inflammatory bowel disease affecting the colon and rectum, marked by periods of exacerbation and remission. Achieving deep remission is characterized by the absence of symptoms, normalized inflammatory markers, and endoscopic healing, which is linked to an improved long-term outcome. However, identifying the factors that contribute to deep remission remain important due to the variability in treatment responses and clinical presentations. The objective of this study was to assess the frequency of deep remission in patients with UC and to analyze the demographic and clinical factors associated with achieving this level of remission.
Methods:
A retrospective study of 94 UC patients at the IBD Clinic of the General Hospital of Mexico analyzed medical records to assess demographic and clinical variables, including age, gender, disease extent, age at diagnosis, extraintestinal manifestations (EIMs), and treatments. Disease severity was evaluated using the Truelove and Witts scale (clinical), the Mayo sub-score (endoscopic), and the Riley index (histological). Patients were classified as being in deep remission if they achieved clinical, endoscopic, and histological remission, with normalized biochemical markers (C-reactive protein and fecal calprotectin). Statistical analyses, including chi-square tests and T-tests, were performed using SPSS version 29.
Results:
Among the 94 patients studied, 18 (19.1%) achieved deep remission. In terms of gender, 38.9% of patients with deep remission were male and 61.1% were female, with no significant differences compared to patients without deep remission (<italic>P &#x3d;</italic> 0.425). The mean age of patients with deep remission was higher (46.11 &#xb1; 13.26 years) compared to those without deep remission (40.66 &#xb1; 12.55 years), though this difference was not statistically significant (<italic>P &#x3d;</italic> 0.091). Age at diagnosis was similar between both groups (35.83 &#xb1; 14.04 years vs 34.76 &#xb1; 12.23 years, <italic>P &#x3d;</italic> 0.785). Most patients in both groups were classified as E3 according to the Montreal classification, with no significant differences (<italic>P &#x3d;</italic> 0.774). The use of conventional treatment was similar in both groups (77.7% vs 64.4%, <italic>P &#x3d;</italic> 0.423), while biological therapy was more common in patients without deep remission (35.5% vs 22.2%, <italic>P &#x3d;</italic> 0.217). Extraintestinal manifestations were more common in patients with deep remission (38.9% vs 26.3%, <italic>P &#x3d;</italic> 0.306).
Conclusions:
In this study, 19.1% of patients with UC achieved deep remission. No significant differences were found in demographic or clinical factors. These results suggest that the factors evaluated were not significantly associated with deep remission in this cohort, underscoring the need to explore other potential determinants of remission in UC.