In a new study appearing in the Annals of Internal Medicine, some patients with advanced ulcerative colitis (UC) had better outcomes with elective colectomy compared to immunosuppressant therapy, even though this is typically a treatment of last resort.
In this retrospective study, data from the Centers for Medicare and Medicaid Services (CMS) of 32,833 patients aged ≥18 with advanced UC were analyzed on survival rates based on treatment type (surgery or medication). Study patients had advanced UC with at least one hospitalization for UC, two or more corticosteroid prescriptions within a 90-day period, or any prescription for immunosuppressant therapy.
Mortality rates were 34 per 1,000 person-years for elective colectomy and 54 per 1,000 for medical therapy, with the greatest benefit seen in patients aged ≥50. Surgery is typically a treatment of last resort for UC, but this suggests that it could benefit older patients who cannot sustain a disease remission on immunosuppressant therapy. The authors added that medications are typically only effective for 50% of UC patients, but more studies are needed for confirmation of the benefits of surgery over drug treatment for this population.
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