Ulcerative colitis: colectomy, steroid use in anti-TNF era

  • Lund K & al.
  • Aliment Pharmacol Ther
  • 3 Oct 2019

  • International Clinical Digest
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Takeaway

  • Patients aged ≤20 years with ulcerative colitis (UC) in the current era of TNFα inhibitors are at reduced risk for colectomy within 5 years of diagnosis.
  • Most treated with anti-TNFα therapy stopped using corticosteroids after 12 months.

Why this matters

  • Anti-TNFα therapy may allow postponing colectomy, potentially an important treatment outcome for adolescents who are highly focused on body composition and appearance.

Study design

  • Researchers analyzed the health records of patients diagnosed with UC either before or after the advent of anti-TNFα therapy (N=3001; age range, 0-20 years).
  • Funding: The Beckett Foundation; Danish Colitis and Crohn's Foundation; Region of Southern Denmark; University of Southern Denmark.

Key results

  • The 5-year cumulative colectomy rate was 12.3% (95% CI, 10.4%-14.6%) in the pre-anti-TNFα group vs 9.7% (95% CI, 8.4%-11.1%) after the introduction of TNFα.
    • 5-year aHR, 0.76 (95% CI, 0.60-0.96).
  • Corticosteroid treatment declined during follow-up after 6 months (5.4%) and 12 months (1.2%).

Limitations

  • Retrospective design.

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