Rate of Colectomy Increases Within 12 Months of Sequential Therapy for Ulcerative Colitis.

Introduction: Patients with medically refractory ulcerative colitis who previously would have undergone surgery can now elect for subsequent medical therapy.
Methods: In a commercially insured population, we evaluated the proportion of patients initiating second-line, third-line, or fourth-line treatment who underwent colectomy in the following 12 months.
Results: Among 3,325 patients with ulcerative colitis, the colectomy rate within 12 months of a switch in therapy increased from 12% with the first switch to 17% and 19% with the second and third switches, respectively ( P < 0.001).
Discussion: Treatment effectiveness declines with successive switching; however, even after initiating fourth-line therapy, most patients remain surgery-free.
(Copyright © 2023 by The American College of Gastroenterology.)