Analysis of colectomy rates for ulcerative colitis in pre‐ and postbiological eras in Lothian, Scotland

• Published in: Colorectal disease 2021-05, Vol.23 (5), p.1175-1183
• Main Authors: Jenkinson, Philip W., Plevris, Nikolas, Lyons, Mathew, Grant, Rebecca, Fulforth, James, Kirkwood, Kate, Arnott, Ian D., Wilson, David, Watson, Angus J. M., Jones, Gareth‐Rhys, Lees, Charlie W.
• Format: Article
• Language: English
• Subjects: adalimumab; anti‐TNF; biologic; colectomy; golimumab; Immunotherapy; Inflammatory bowel disease; infliximab; Remission; surgery; Ulcerative colitis; vedolizumab
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.15491

Aim 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. Method 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. Results Rates of initiation of maintenance biological therapy increased from 0.05 per 100 UC patients in 2005 to 1.26 in 2018 (p