Treatment and outcome of ulcerative colitis during the first 10 years after diagnosis in a prospectively followed population-based cohort

Abstract

Background and aims

There is a shortage of studies evaluating the effect of prevalent use of immunomodulators (IMMs) and biologicals on the clinical course of ulcerative colitis (UC) during 10 years. The aim of the present study is to report the use of drugs and surgery as well as mortality in a population based setting.

Methods

Between 2005 and 2009, we identified 330 patients in all ages (3–86 years) with an incident diagnosis of UC in the County of Uppsala, Sweden. They were followed prospectively and the medical notes were retrospectively analysed with special reference to the use of drugs, surgery and mortality.

Results

Median follow-up was 11.2 years (inter-quartile range 10.2–12.7). Out of the 330 patients, 298 (90.3%) could be followed for at least 10 years or until death. The cumulative exposure to different drugs was as follows: 5-ASA 96.6%, steroids 73.3%, IMMs 35.4% and biologicals 11.4%. Fourteen patients (4.6%) needed a colectomy during the observation time. Overall mortality in 10 years was 7% (23/330) whereof three patients died as a consequence of the disease or its treatment. Three patients (0.9%) were diagnosed with colonic cancer of whom two also had sclerosing cholangitis.

Conclusions

A frequent use of IMMs and biologicals during 10 years, can result in a low need for colectomy without increased mortality compared to previous reports.

Keywords:

• Ulcerative colitis
• clinical course
• outcome
• colectomy

Author contributions

Guarantor of the article: Anders Rönnblom. AR and UK designed the study, AR collected the medical data and UK the surgical data. AR performed the statistical analysis. Both authors wrote the manuscript and reviewed and approved the final version of the manuscript.

Disclosure statement

The authors have no conflicts of interest to declare.

Additional information

Funding

This work was supported by grants from the Uppsala University Hospital Research Foundation.