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Alissa Rothman1, Lara Chaaban2, Joanna Melia2

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Male ulcerative colitis (UC) patients face higher risks of colectomy, hospitalization, and mortality compared to females. This study highlights significant sex-based differences in UC outcomes, particularly in severe disease.

Keywords:
ColectomyHospitalizationMortalitySex differencesUlcerative colitis

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Area of Science:

  • Gastroenterology
  • Immunology
  • Clinical Epidemiology

Background:

  • Sex-based differences in immune-mediated diseases are increasingly recognized.
  • Limited research exists on sex disparities in ulcerative colitis (UC), especially severe forms.
  • Previous studies suggest potentially lower colectomy rates in female UC patients.

Purpose of the Study:

  • To investigate the association between sex and outcomes in ulcerative colitis (UC) patients.
  • To specifically assess outcomes in severe UC requiring hospitalization.
  • To compare colectomy, hospitalization, and mortality risks between male and female UC patients.

Main Methods:

  • Retrospective cohort study using the TriNetX multi-institutional database.
  • Propensity score matching to compare male and female UC patients.
  • Subgroup analyses included hospitalized patients, those receiving IV steroids, and infliximab.

Main Results:

  • Males exhibited significantly higher risks of colectomy, hospitalization, and mortality at 1 and 5 years post-diagnosis.
  • These disparities persisted in analyses of hospitalized UC patients and those receiving early IV steroids.
  • Differences in colectomy rates were also noted at 1 year for patients receiving infliximab.

Conclusions:

  • Male patients with ulcerative colitis (UC) demonstrate a higher risk profile for adverse outcomes.
  • Colectomy, hospitalization, and mortality risks are elevated in males compared to females with UC.
  • Findings underscore the importance of considering sex as a factor in UC management and prognosis.