Analysis of colectomy rates for ulcerative colitis in pre- and postbiological eras in Lothian, Scotland.
adalimumab
anti-TNF
biologic
colectomy
golimumab
infliximab
surgery
ulcerative colitis
vedolizumab
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
revised:
30
10
2020
received:
06
07
2020
accepted:
07
12
2020
pubmed:
23
12
2020
medline:
1
9
2021
entrez:
22
12
2020
Statut:
ppublish
Résumé
Biological treatment is effective in maintaining remission in ulcerative colitis (UC), although the effect on colectomy rates remains unclear. In the UK the use of antitumour necrosis factor and anti-α4β7 treatments for maintenance therapy in UC was restricted until 2015. The aim of this study was to describe the impact that this change in the prescribing of biologicals had on colectomy rates for UC. All patients (adult and paediatric) with a diagnosis of UC who received maintenance biological treatment and/or underwent a colectomy in Lothian, Scotland between 2005 and 2018 were identified. Linear and segmental regression analyses were used to identify the annual percentage change (APC) and temporal trends (statistical joinpoints) in biological prescription and colectomy rates. Rates of initiation of maintenance biological therapy increased from 0.05 per 100 UC patients in 2005 to 1.26 in 2018 (p < 0.001). Colectomy rates per 100 UC patients fell from 1.47 colectomies in 2005 to 0.44 in 2018 (p < 0.001). The APC for colectomy decreased by 4.1% per year between 2005 and 2014 and by 18.9% between 2014 and 2018. Temporal trend analysis (2005-2018) identified a significant joinpoint in colectomy rates in 2014 (p = 0.019). The use of maintenance biological therapy increased sharply following the change in guidance. This has been paralleled by a significant reduction in the rates of colectomy over the same time period.
Substances chimiques
Tumor Necrosis Factor-alpha
0
Infliximab
B72HH48FLU
Adalimumab
FYS6T7F842
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1175-1183Subventions
Organisme : Medical Research Council
ID : G0800675
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S034919/1
Pays : United Kingdom
Organisme : MRF
ID : MRF_C0482
Pays : United Kingdom
Informations de copyright
© 2020 The Association of Coloproctology of Great Britain and Ireland.
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