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Twenty-Year Trends in Colectomy Rates and Advanced Therapy Prescribing in Lothian, Scotland.

Alexander T Elford1,2, Nathan Constantine-Cooke3,4, Phil W Jenkinson1

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Alimentary Pharmacology & Therapeutics
|June 16, 2025
PubMed
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Advanced therapy use for ulcerative colitis (UC) has risen significantly, coinciding with a notable decrease in colectomy rates over two decades. This trend suggests improved management strategies for UC patients.

Keywords:
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Area of Science:

  • Gastroenterology
  • Clinical Epidemiology
  • Pharmacology

Background:

  • Conflicting evidence exists regarding the effect of advanced therapy prescribing on colectomy rates in ulcerative colitis (UC).
  • Understanding these trends is crucial for optimizing patient care and resource allocation in UC management.

Purpose of the Study:

  • To analyze trends in advanced therapy prescribing for UC patients.
  • To determine colectomy rates in UC patients over a 20-year period.
  • To investigate the relationship between advanced therapy use and colectomy incidence.

Main Methods:

  • Utilized data from the Lothian IBD Registry, a validated population cohort.
  • Collected incidence and prevalence data for UC patients from 2004 to 2023.
  • Employed piecewise linear regression to identify temporal trends in prescribing and colectomy rates.

Main Results:

  • UC prevalence increased from 216 to 441 per 100,000 population.
  • First-line advanced therapy prescribing rose from 0% to 2.82% per 100 UC patients.
  • Colectomy rates decreased from 2.48% to 0.22% per 100 UC patients, with a significant drop after 2013.

Conclusions:

  • Advanced therapy utilization in UC has substantially increased.
  • Colectomy incidence in the UC population has significantly decreased over the study period.
  • A temporal association exists between increased advanced therapy prescribing and decreased colectomy rates.