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

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. 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. 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 (<i>p</i> &lt; 0.001), and mean calprotectin decreased from 2113.2 to 106.9 mcg/g (<i>p</i> &lt; 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 (<i>p</i> = 0.002). Significant correlations were observed between NHI with MES and IBDQ-36 at week 24. 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.