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 17 June 2018

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News

Changes in medical management and colectomy rates

A population-based cohort study in the latest issue of the Alimentary Pharmacology & Therapeutics investigates the epidemiology and natural history of ulcerative colitis.

News image

Whether the epidemiology of ulcerative colitis (UC) has changed during recent decades is partly unknown.

Dr Halfvarson and colleagues from Sweden depicted temporal trends in the epidemiology and medical treatment of UC as well as the long-term risk of progression in disease extent and colectomy, during 1963-2010.

Patients were identified by evaluation of all medical records in the archive of the Colitis Clinic, Örebro University Hospital.

Comparisons were made between 3 time periods, 1963-1975, 1976-1990 and 1991-2005.

The researchers found that the annual age-standardized incidence increased from 4 to 19 per 100,000 during the study period.

Correspondingly, the prevalence increased from 44 to 474 per 100,000 between 1965 and 2010.

The colectomy rate at 10 years was 14%
Alimentary Pharmacology & Therapeutics

The team noted that a higher proportion of males than females had extensive colitis at diagnosis.

The researchers noted that the risk for progression in disease extent was 35% and 19% at 10 years, for patients with proctitis and left-sided colitis, respectively.

The use of 5-aminosalicylates, within 10 years, rise from 79% to 92% between 1963-1975 and 1976-1990.

Thiopurine use increased from 7% in 1976-1990 to 34% during 1991-2005.

The research team found that the colectomy rate at 10 years was 14%, and the risk was lower among patients diagnosed in 1991-2005 compared to 1963-1975.

Dr Halfvarson's team concludes, "The incidence and prevalence of UC increased over time, and the observed prevalence in 2010 is among the highest reported."

"In parallel, a decrease in colectomy rates was observed during the most recent decades, potentially reflecting improved medical treatment."

Aliment Pharmacol Ther 2017: 46(8): 748–757
22 September 2017

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