Surgery rates in IBD affected by immunomodulating therapy, Resection rates in Crohn’s disease and colectomy in ulcerative colitis remained high, but below some historical data, possibly due to an increase in the use of immunomodulating therapy, according to new 7-year follow-up data.
Researchers first registered 562 cases of ulcerative colitis, Crohn’s disease or unclassified inflammatory bowel disease (IBD) in a small area of Copenhagen, Denmark, from January 2003 through December 2004. Then medical records from November 2011 through November 2012 were analyzed, with follow-up data available for 213 CD and 300 UC patients. Using data from national health administrative databases, researchers cross-checked clinical information on surgery, cancer and death.
Disease localization and behavior changes were reported in 23.9% of CD cases and in 15% of UC cases (Vienna classification), with 28.3% of the UC patients experiencing disease progression during follow-up.
Among CD patients, reported use of systemic steroids was 86.4%; immunomodulators, 64.3%; and anti-tumor necrosis factor agents, 23.5%.
The first-time intestinal resection rate in CD was 29.1%, with a 7-year cumulative risk of 28.5%. Among UC patients, the 7-year cumulative risk for colectomy was 12.5%.
The resection rate in CD and the colectomy rate in UC are still relatively high, although these rates are markedly lower than rates previously reported in Denmark, the researchers wrote. This difference could be due to an altered surgical approach or an increase in the use of immunosuppressants, especially in CD.