Improving Clinical, Endoscopic and Histological Outcomes in Inflammatory Bowel Disease

This thesis demonstrates that histologic healing in Crohn's disease and histological healing or normalisation in ulcerative colitis are associated with improved short- and long-term clinical outcomes. Vedolizumab, a novel anti-integrin medication, is effective at inducing mucosal and histological healing in IBD and can be effectively combined with calcineurin inhibitors to rapidly induce and maintain remission in patients with severe disease. However, a treatment gap remans and IBD patients with primary sclerosing cholangitis do not gain additional benefit in regard to their liver disease. These findings hold the prospect of changing both future IBD clinical care and clinical trial design.