Ulcerative colitis flare-ups linked to polypharmacy

  • Wang J & al.
  • Intest Res
  • 14 Oct 2019

  • International Clinical Digest
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Takeaway

  • Ulcerative colitis (UC) flare-ups are more likely in patients with the disease who take multiple medications.

Why this matters

  • About one-third of patients with UC have major polypharmacy, taking ≥5 medications for other health conditions.
  • Clinicians should consider polypharmacy in UC management and take steps to minimize unnecessary medications.

Study design

  • Researchers analyzed the health records of patients with UC treated at a tertiary medical center outpatient clinic (N=457), exploring associations between the major and minor polypharmacy (taking ≥5 or 2-4 non-UC medications, respectively) and the outcomes such as disease flare, therapy escalation, UC-related hospitalization, and surgery within 5 years of the first encounter.
  • Funding: None.

Key results

  • Polypharmacy rates overall were 29.8% (major) and 40.9% (minor).
  • Associated factors included increased age (P<.001 female sex functional gastrointestinal disorders and psychiatric disease>
  • Major polypharmacy was significantly associated with increased risk for disease flare (OR, 4.00; 95% CI, 1.66-9.62) after adjusting for age, sex, functional GI disorders, and psychiatric disease.
  • Major polypharmacy was not associated with increased therapy escalation, hospitalization, or surgery.

Limitations

  • The study was retrospective and single center, did not show causation, and did not account for clinical disease activity or endoscopy scores.