Aim: We have previously shown that CRP < 2.9 mg/L is a better predictor of endoscopic remission (ER) than CRP < 5 mg/L in ulcerative colitis (UC). Here, we prospectively evaluate CRP and FCP cut-offs and compare them in predicting ER and histological remission (HR) in UC. Method: One hundred thirty-five steroid-free UC patients were evaluated prospectively. ER was defined as Mayo endoscopic sub-score 0–1. In colonoscopy, the colon was evaluated as seven segments: rectum, sigmoid, descending, proximal-transverse, distal-transverse, ascending colon, and cecum. Two biopsies of each segment were evaluated for histological inflammation and graded using the Nancy and Geboes scores. All segment biopsies with Nancy < 1 and Geboes < 2 were defined as HR. Results: The optimum cut-off values for FCP and CRP were 120 μg/g and 2.75 mg/L for ER, respectively. AUC values of FCP and CRP were similar for ER and Mayo-0 disease in ROC analysis. CRP and FCP also had similar performances with these cut-offs regarding ER. While CRP was a predictor to assess the extensiveness of active UC, FCP was not. ROC analysis showed no difference between CRP and FCP regarding HR. Cut-off values for HR were 2.1 mg/L and 55 μg/g for CRP and FCP, respectively. CRP and FCP, in combination with the mentioned cut-off values, detected ER and HR in nearly 2/3 and ½ of the patients, respectively, with high specificity. Conclusions: Reappraised CRP (ER: 2.75 mg/L, HR: 2.1 mg/L) has as much diagnostic contribution as relevant FCP in predicting ER and HR and contributes more to revealing the proximal extension in active colitis compared to FCP. Relevant CRP and FCP combinations may improve the prediction rates.

To assess the impact of the biological era on colectomy rates in ulcerative colitis (UC) patients and identify factors associated with the necessity for colectomy in a large cohort from Eastern Europe. A retrospective cohort study was conducted on UC patients followed at a tertiary care center covering 1999 to 2021. Patients who underwent colectomy due to disease activity were compared to those who did not. Factors related to colectomy and the influence of the biological era were analyzed. Among 1197 patients with a median follow-up of 3.3 years, 18% received biological agents and 5.3% underwent colectomy due to disease activity. The colectomy rate was lower in the biological era compared to the pre-biological era (2% vs. 12%; p < 0.001). Independent predictors of colectomy included steroid dependency, steroid resistance, lack of mucosal remission, and elevated CRP levels. Patients who achieved and maintained mucosal remission and had CRP levels below 3 mg/L had a significantly lower risk of colectomy. The biological era has significantly reduced colectomy rates in UC patients. Achieving mucosal remission and maintaining low CRP levels are essential for preventing colectomy and improving long-term outcomes.

To evaluate real-world diagnostic and therapeutic approaches to polymyalgia rheumatica (PMR) among Turkish rheumatologists and compare them with international guideline recommendations. A cross-sectional online survey was conducted among rheumatologists practicing in Turkiye between September and October 2025. A self-administered 29-item questionnaire was distributed through professional communication networks. The survey was developed with reference to the 2012 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria and international management guidelines. It assessed self-reported diagnostic approaches, screening practices for giant cell arteritis (GCA), treatment strategies, and follow-up and monitoring practices. Data were recorded and analyzed in a de-identified manner using descriptive statistics. A total of 101 rheumatologists participated in the survey. Diagnostic approaches varied substantially: use of the 2012 EULAR/ACR criteria was reported by 65 (64.4%), referral to the 2010 British Society for Rheumatology/British Health Professionals in Rheumatology (BSR/BHPR) guideline by 10 (9.9%), and primary reliance on clinical judgment by 76 (75.2%). Elevated erythrocyte sedimentation rate and/or C-reactive protein (ESR/CRP) were considered necessary for diagnosis by 92 (91.1%). Use of imaging modalities, including ultrasonography (US), magnetic resonance imaging (MRI), and positron emission tomography (PET), was highly heterogeneous, and routine screening for giant cell arteritis (GCA) was reported by 25 (24.8%). Glucocorticoid (GC) monotherapy was the preferred first-line treatment among 76 participants (75.2%), with most clinicians selecting guideline-recommended starting doses (12.5–25 mg/day) and initiating tapering between weeks 4 and 8. Disease-modifying antirheumatic drugs (DMARDs) were most commonly introduced at first relapse (55, 54.5%). Although osteoporosis risk assessment was reported by 86 (85.1%), the use of dual-energy X-ray absorptiometry (DXA), the Fracture Risk Assessment Tool (FRAX), and referral for exercise programs remained inconsistent. Although initial GC therapy was generally consistent with guideline recommendations, considerable heterogeneity was observed in diagnostic approaches, imaging use, screening for GCA, and long-term monitoring practices, indicating persistent gaps between guidelines and real-world clinical practice.