Abstract Background Histologic activity has emerged as an aspirational therapeutic goal in IBD management. It is not yet a formal treatment-target in either CD or UC. However, it could be used as an adjunct to mucosal healing to represent a deeper level of healing. We investigated histologic remission (HR) rates and potential predictors of achieving histologic remission in a prospective IBD cohort. Methods We conducted a retrospective subgroup analysis of data collected from IBD patients enrolled in an ongoing prospective cohort study. Clinical, biological, endoscopic data (including the Mayo endoscopic subscore and SES-CD score) and histopathology results were available at multiple time-points for the enrolled patients (annual visits). Mucosal healing (MH) was defined as SES-CD 3 or Mayo endoscopic score=0i. Results 219 patients (88 CD, 131 UC) were enrolled in our study and were prospectively followed for a median length of 2 years (range 0-5 years), totaling 452 study visits. MH was recorded for 51 (27 UC, 24 CD, 23,2%) patients at 76(16%) different study visits. Overall, only 35(15%) patients achieved HR. In the MH subgroup, histologic remission was achieved in 30(58%) patients. After logistic regression analysis, none of the investigated factors (diagnosis, disease fenotype, gender, smoking status, disease duration, ongoing biologic treatments,corticosteroids, C-reactive protein, SIBDQ score) was associated with histologic remission. Conclusion Mucosal healing and endoscopic remission rates are low in real-life settings. Frequently used patient and disease related factors, including mucosal healing are not reliable predictors for histologic remission. Well validated, reliable, and accepted measuring tool as well as predictor factors for this potential therapeutic target should be investigated in further studies. Reference: 1. Turner D, Ricciuto A, Lewis A, D’Amico F, Dhaliwal J, Griffiths AM, Bettenworth D, Sandborn WJ, Sands BE, Reinisch W, Schölmerich J, Bemelman W, Danese S, Mary JY, Rubin D, Colombel JF, Peyrin-Biroulet L, Dotan I, Abreu MT, Dignass A; International Organization for the Study of IBD. 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. 2021 Apr;160(5):1570-1583. doi: 10.1053/j.gastro.2020.12.031. Epub 2021 Feb 19. PMID: 33359090. Conflict of interest: Bardasu, Sebastian: No conflict of interest Bengus, Andreea: No conflict of interest Voiosu, Andrei: No conflict of interest Voiosu, Theodor: No conflict of interest Mateescu, Radu Bogdan: No conflict of interest Mrs. State, Roxana Monica:
Bardasu et al. (2026) studied this question.