Colectomy rates in ulcerative colitis: A systematic review and meta-analysis
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Authors
Dai, N.
Haider, O.
Askari, A.
Segal, J.P.
Issue Date
2023
Type
Scientific Paper
Language
Keywords
Research Subject Categories::MEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Internal medicine::Gastroenterology
Alternative Title
Abstract
Abstract
Background: Surgical management in Ulcerative Colitis (UC) is typically utilised in medically refractory cases and, therefore, it is a useful marker for efficacy of medical management.
Aims: To understand the changing prevalence of colectomy in UC over time.
Methods: A systematic review was conducted using MEDLINE (1946-2021), EMBASE and EMBASE classic (1947-2021) to identify studies with a population of n>500 that reported colectomy rates in UC patients >18 years old. The primary outcome was the prevalence of colectomy at 1-, 5- and 10-years post-diagnosis. Secondary outcomes included colectomy rates in the pre-biologics (defined as pre-2004) and post-biologics eras (defined as post-2004).
Results: Thirty-one studies with 294,359 patients with UC were included for review and meta-analysis. The prevalence of colectomy at 1-, 5- and 10-years post-diagnosis were 3% (95% CI 2%-6%), 5% (95% CI 2%-9%), 10% (95% CI 6%-16%) respectively. The pooled relative risk for colectomy in the post-biologics era was 0.68 (95% CI 0.42 to 1.09, p=0.10) at 1-year and 0.71 (95% CI 0.56 to 0.91, p<0.01) at 5-years post-diagnosis.
Conclusion: The overall colectomy rate has decreased over the past three decades. Biologics may have played a role in reducing the risk of colectomy, however the relative risk reduction is likely to be modest.
Keywords: Biologics; Colectomy; Ulcerative colitis.
Copyright © 2022. Published by Elsevier Ltd.
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Conflict of interest statement
Declaration of Competing Interest Jonathan Segal has received speaker fees for Takeda Janssen and Abbvie. All other authors declare no conflicts of interest
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Description
Citation
Dai N, Haidar O, Askari A, Segal JP. Colectomy rates in ulcerative colitis: A systematic review and meta-analysis. Dig Liver Dis. 2023 Jan;55(1):13-20. doi: 10.1016/j.dld.2022.08.039. Epub 2022 Sep 28. PMID: 36180365.