苏格兰洛锡安地区结肠切除术率及先进治疗处方的二十年趋势

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

作者信息

Elford Alexander T, Constantine-Cooke Nathan, Jenkinson Phil W, Gros Beatriz, Plevris Nikolas, Lyons Mathew, Ong Solomon, Greenlees Neil, Velasco-Pardo Victor, O'Hare Claire, Ventham Nicholas T, Henderson Paul, Wilson David C, Din Shahida, Noble Colin L, Jones Gareth-Rhys, Arnott Ian, Lees Charlie W

机构信息

Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK.

Faculty of Medicine, The University of Melbourne, Melbourne, Australia.

出版信息

Aliment Pharmacol Ther. 2025 Oct;62(7):699-709. doi: 10.1111/apt.70240. Epub 2025 Jun 16.

DOI:10.1111/apt.70240

PMID:40521877

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12422722/

Abstract

BACKGROUND

The impact of advanced therapy prescribing on colectomy rates in ulcerative colitis (UC) is unknown with conflicting published evidence.

AIM

To describe advanced therapy prescribing trends and colectomy rates for patients with UC in Lothian, UK between January 1st, 2004 and December 31st, 2023.

METHODS

We obtained incidence and prevalence data from the Lothian IBD Registry, a rigorously validated population cohort. We report advanced therapy prescribing and colectomy data as raw numbers and annual incidence rates. We used piecewise linear regression analyses to identify temporal trends in prescription and colectomy rates.

RESULTS

The prevalence of UC increased from 216 to 441 per 100,000 population in the 20 years from 2004, culminating in a total of 4115 patients with UC in 2023. We identified 720 patients who had received an advanced therapy. Prescribing of first-line advanced therapy increased from 0 in 2004 to 115 in 2023, equating to 0.00 and 2.82 per 100 patients with UC. We identified 563 patients of the prevalent UC population who had colectomy, of whom 68% were performed as emergencies. Absolute colectomy numbers decreased from 42 in 2004 to 7 in 2023, equating to 2.48 and 0.22 per 100 patients with UC. A join point in 2013 was found for both increased advanced therapy prescribing and decreased colectomy rates.

CONCLUSION

The incidence of colectomy in the UC population has decreased over time while the use of advanced therapies has greatly increased.

摘要

背景

关于晚期治疗方案的开具对溃疡性结肠炎（UC）患者结肠切除术发生率的影响尚不清楚，已发表的证据相互矛盾。

目的

描述2004年1月1日至2023年12月31日期间英国洛锡安地区UC患者的晚期治疗方案开具趋势和结肠切除术发生率。

方法

我们从洛锡安炎症性肠病登记处获取了发病率和患病率数据，该登记处是一个经过严格验证的人群队列。我们将晚期治疗方案开具和结肠切除术数据报告为原始数字和年发病率。我们使用分段线性回归分析来确定处方率和结肠切除术发生率的时间趋势。

结果

在2004年以来的20年里，UC的患病率从每10万人中的216例增加到441例，到2023年共有4115例UC患者。我们确定了720例接受过晚期治疗的患者。一线晚期治疗方案的开具从2004年的0例增加到2023年的115例，相当于每100例UC患者中分别为0.00例和2.82例。我们在现患UC人群中确定了563例行结肠切除术的患者，其中68%是急诊手术。结肠切除术的绝对数量从2004年的42例下降到2023年的7例，相当于每100例UC患者中分别为2.48例和0.22例。在2013年发现了晚期治疗方案开具增加和结肠切除术发生率下降的连接点。