HomePublicationsCongress AbstractsAbstracts 2012Poster presentations: Clinical: Therapy and observation (2012)P317. Incidence of and impact of medications on colectomy in newly diagnosed ulcerative colitis in the era of biologics

* = Presenting author

Poster presentations: Clinical: Therapy and observation (2012)

P317. Incidence of and impact of medications on colectomy in newly diagnosed ulcerative colitis in the era of biologics


N. Willet1, C. Pillot1, A. Oussalah1, V. Billioud1, J.‑B. Chevaux1, L. Bresler2, M.‑A. Bigard1, J.‑L. Guéant1, L. Peyrin-Biroulet1

1University Hospital of Nancy, Université Henri Poincaré 1, Inserm U954 and Department of Hepato-Gastroenterology, Vandoeuvre-les-Nancy, France; 2University Hospital of Nancy, Department of Digestive Surgery, Vandoeuvre-les-Nancy, France



Background: The cumulative incidence of colectomy and the impact of 5‑aminosalicylates (5-ASA), azathioprine and anti-tumor necrosis factor (TNF) treatment on the long-term need for surgery are unknown in ulcerative colitis in the era of biologics.

Methods: This was an observational study of a referral centre cohort. The cumulative incidence of ulcerative colitis-related colectomy was estimated using the Kaplan–Meier method. Independent predictors of surgery were identified using Cox proportional hazards regression with propensity scores adjustment. The electronic charts of 151 incident cases of ulcerative colitis from Nancy University Hospital, France, diagnosed between 2000 and 2008, were reviewed through January 2010.

Results: The median follow-up time per patient was 58 months. Twenty-one (14%) underwent surgery. The cumulative probabilities of colectomy were respectively 1.3% and 13.5% at 1 and 5 years from the time of diagnosis. The probability of receiving oral mesalamine at 5 years was 68.1%. The corresponding figures were 48.9% for azathioprine and 29.0% for infliximab. For corticosteroids, methotrexate and ciclosporin these figures were 75%, 8.8%, and 11.5%, respectively. Using multivariate Cox proportional hazards regression analysis after propensity score adjustment, previous use of ciclosporin was the only independent predictor for colectomy (HR = 4.41; 95% CI 1.75 to 1.13).

Conclusions: About one-tenth of patients still require colectomy for ulcerative colitis at 5 years in the era of biologics. Oral 5‑ASA, azathioprine and anti‑TNF therapy are not associated with reduced need for colectomy.