Analysis of colectomy rates for ulcerative colitis in pre- and postbiological eras in Lothian, Scotland
Analysis of colectomy rates for ulcerative colitis in pre- and postbiological eras in Lothian, Scotland
复制标题
DOI：
10.1111/codi.15491
复制
发表时间：
2021-02-17
影响因子：
3.4
通讯作者：
Lees, Charlie W.
中科院分区：
文献类型：
--
作者：
Jenkinson, Philip W.;Plevris, Nikolas;Lees, Charlie W.
目的生物治疗是维持溃疡性结肠炎（UC）缓解的有效方法，但其对结肠切除率的影响尚不清楚。在英国，抗肿瘤坏死因子和抗α 4 β 7治疗在UC维持治疗中的使用受到限制，直到2015年。本研究的目的是描述的影响，这种变化的处方生物制剂结肠切除率为UC.Method所有患者（成人和儿童）与UC的诊断谁接受维持生物治疗和/或接受结肠切除术在苏格兰洛锡安之间2005年和2018年进行了确定。使用线性和分段回归分析来确定生物处方和结肠切除率的年度百分比变化（APC）和时间趋势（统计学联合点）。结果维持生物治疗的启动率从2005年的每100名UC患者0. 05增加到2018年的1. 26（p <0. 001）。每100例UC患者的结肠切除率从2005年的1.47例结肠切除术下降到2018年的0.44例（p < 0.001）。结肠切除术的APC在2005年至2014年间每年下降4.1%，在2014年至2018年间下降18.9%。时间趋势分析（2005-2018年）发现2014年结肠切除率的显著联合点（p = 0.019）。结论指南变更后维持生物治疗的使用急剧增加。这已经被同期结肠切除率的显著下降所证实。
Aim Biological treatment is effective in maintaining remission in ulcerative colitis (UC), although the effect on colectomy rates remains unclear. In the UK the use of antitumour necrosis factor and anti-alpha 4 beta 7 treatments for maintenance therapy in UC was restricted until 2015. The aim of this study was to describe the impact that this change in the prescribing of biologicals had on colectomy rates for UC.Method All patients (adult and paediatric) with a diagnosis of UC who received maintenance biological treatment and/or underwent a colectomy in Lothian, Scotland between 2005 and 2018 were identified. Linear and segmental regression analyses were used to identify the annual percentage change (APC) and temporal trends (statistical joinpoints) in biological prescription and colectomy rates.Results Rates of initiation of maintenance biological therapy increased from 0.05 per 100 UC patients in 2005 to 1.26 in 2018 (p < 0.001). Colectomy rates per 100 UC patients fell from 1.47 colectomies in 2005 to 0.44 in 2018 (p < 0.001). The APC for colectomy decreased by 4.1% per year between 2005 and 2014 and by 18.9% between 2014 and 2018. Temporal trend analysis (2005-2018) identified a significant joinpoint in colectomy rates in 2014 (p = 0.019).Conclusion The use of maintenance biological therapy increased sharply following the change in guidance. This has been paralleled by a significant reduction in the rates of colectomy over the same time period.