Clinical course of ulcerative colitis: Frequent use of biologics and low colectomy rate first year after diagnosis—results from the IBSEN III inception cohort
Strande, Vibeke; Lund, Charlotte; Hagen, Milada; Bengtson, May-Bente; Boyar Cetinkaya, Raziye; Detlie, Trond Espen; Frigstad, Svein Oskar; Høie, Ole Ingebreth; Medhus, Asle Wilhelm; Henriksen, Magne; Holten, Kristina Ingeborg; Hovde, Øistein; Huppertz-Hauss, Gert; Johansen, Ingunn; Olsen, Bjørn Christian Elias Grova; Opheim, Randi; Ricanek, Petr; Torp, Roald; Tønnessen, Tor; Vatn, Simen Svendsen; Aabrekk, Tone Bergene; Høivik, Marte Lie; Kristensen, Vendel Ailin
Peer reviewed, Journal article
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Date
2024Metadata
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Abstract
Background
The introduction of biologic therapies and the ‘treat-to-target’ treatment strategy may have changed the disease course of ulcerative colitis (UC).
Aims
To describe the early disease course and disease outcome at 1-year follow-up in a population-based inception cohort of adult patients with newly diagnosed UC.
Methods
The Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III study is a population-based inception cohort study with prospective follow-up. Patients newly diagnosed with inflammatory bowel disease during 2017–2019 were included. Patients ≥18 years at diagnosis of UC who attended the 1-year follow-up were investigated. We registered clinical, endoscopic and demographic data at diagnosis and 1-year follow-up.
Results
We included 877 patients with UC (median age 36 years (range: 18–84), 45.8% female). At diagnosis, 39.2% presented with proctitis, 24.7% left-sided colitis and 36.0% extensive colitis. At the 1-year follow-up, 13.9% experienced disease progression, and 14.5% had received one or more biologic therapies. The colectomy rate was 0.9%. Steroid-free clinical remission was observed in 76.6%, and steroid-free endoscopic remission in 68.7%. Anaemia and initiation of systemic steroid treatment at diagnosis were associated with biologic therapy within the first year after diagnosis.
Conclusion
In this population-based inception cohort, colectomy rate in the first year after diagnosis was low, and a high proportion of patients were in remission at 1-year follow-up. The use of biologic therapy increases, consistent with findings from previous studies.