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News

Surgery rates in IBD in the era of immunomodulating therapy

This month's issue of the American Journal of Gastroenterology examines disease course and surgery rates in IBD.

News image

Dr Marianne Vester-Andersen and colleagues from Denmark performed a population-based 7-year follow-up of incident patients with ulcerative colitis (UC) or Crohn's disease (CD).

The research team described disease progression and surgery rates in an era influenced by the increased use of immunosuppressants and the introduction of biological therapy.

From 2003 to 2004, all incident cases of patients diagnosed with UC, CD, or inflammatory bowel disease unclassified in a well-defined Copenhagen area were registered.

Medical records were reviewed from 2011 to 2012, and clinical data were registered.

Clinical data on surgery, cancer, and death were cross-checked with register data from national health administrative databases in order to include missed data.

The team evaluated 513 patients.
28% of the 300 ulcerative colitis patients had disease progression during the follow-up
American Journal of Gastroenterology

The researchers noted that 26 patients changed diagnosis during the follow-up.

Changes in disease localization and behavior in CD according to the Vienna classification were observed in 24% and 15% of the patients, respectively, during follow-up.

In total, 28% of the 300 ulcerative colitis patients had disease progression during the follow-up.

The researchers found that overall use of systemic steroids, immunomodulators, and anti-tumor necrosis factor agents in CD was 86%, 64%, and 24%, respectively.

The rate of first-time intestinal resection in CD was 29%, and the 7-year cumulative risk was 29%.

The team found that the cumulative risk of colectomy in UC was 13% at 7 years.

Dr Vester-Andersen's team concludes, "UC and CD are dynamic diseases that progress in extent and behavior over time."

"The resection rate in CD and the colectomy rate in UC are still relatively high, although the rates seem to have decreased compared with historic data, which could be due to an increase in the use of immunomodulating therapy."

Am J Gastroenterol 2014; 109:705–714
22 May 2014

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