The Lancet Gastroenterology & Hepatology Journal Cover December 1st 2017

Improving remission rates in newly diagnosed paediatric ulcerative colitis. The optimal strategy for achieving e ective and prolonged remission in newly diagnosed paediatric ulcerative colitis is contentious, despite the publication of several sets of guidelines.1,2 Predictors of disease course and severity at diagnosis are poorly explored but likely to be important determinants of initial treatment and short-term and long-term outcomes. In The Lancet Gastroenterology & Hepatology, Je rey Hyams and colleagues publish their initial report of the multicentre PROTECT study, which investigated characteristics at diagnosis that were associated with subsequent need for treatment escalation and factors associated with corticosteroid-free remission at 12 weeks.3 This work represents systematic reporting of real clinical experience, strengthened by the inclusion of patients with varying disease severity from 29 centres, who were treated in accordance with an agreed approach, creating the potential to then explore the impact of treatment and predictors of outcome.