Ulcerative colitis flare-ups linked to polypharmacy

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 (P=.019), functional gastrointestinal (GI) disorders (P<.001), and psychiatric disease (P<.001).
• 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.