CME – Ulcerative Colitis Treatments: Comparing Mortality

CME – Ulcerative Colitis Treatments: Comparing Mortality

According to data from the Crohn’s & Colitis Foundation of America, ulcerative colitis (UC) is an inflammatory bowel disease that affects up to 700,000 Americans. Current medications that are used for UC—which often include corticosteroids or long-term immunosuppressant therapy—do not lead to remission for all patients, and relapse rates are high even among those who achieve remission using medical therapies. “While medical therapy is generally safe for people with UC, only about one-third of patients experience a long-term response to medications,” explains Meenakshi Bewtra, MD, MPH, PhD. Patients also must endure a trial-and-error approach until they find a medication that works for them, which can severely impact quality of life (QOL). In addition, some UC medications come with higher risks of serious side effects. As an alternative to medical therapy, patients with UC can undergo elective colectomy, a surgery which involves performing a total proctocolectomy with ileostomy and, in many cases, restorative ileal pouch anal anastomosis. “Surgery has always been an option for patients with UC, but it is often viewed as a last resort,” says Dr. Bewtra. Research shows that elective colectomy is associated with low morbidity and mortality, but it may also alter patients’ QOL following the procedure.   Assessing Survival QOL, morbidity, and mortality are important factors that drive treatment decisions for patients with UC and their physicians. Dr. Bewtra and colleagues had a retrospective study published in Annals of Internal Medicine that looked at whether or not patients with advanced UC had better survival by undergoing elective colectomy or by being treated with medical therapy. “It’s important to clarify if elective surgery for UC can...
Ulcerative Colitis Treatments: Comparing Mortality

Ulcerative Colitis Treatments: Comparing Mortality

According to data from the Crohn’s & Colitis Foundation of America, ulcerative colitis (UC) is an inflammatory bowel disease that affects up to 700,000 Americans. Current medications that are used for UC—which often include corticosteroids or long-term immunosuppressant therapy—do not lead to remission for all patients, and relapse rates are high even among those who achieve remission using medical therapies. “While medical therapy is generally safe for people with UC, only about one-third of patients experience a long-term response to medications,” explains Meenakshi Bewtra, MD, MPH, PhD. Patients also must endure a trial-and-error approach until they find a medication that works for them, which can severely impact quality of life (QOL). In addition, some UC medications come with higher risks of serious side effects. As an alternative to medical therapy, patients with UC can undergo elective colectomy, a surgery which involves performing a total proctocolectomy with ileostomy and, in many cases, restorative ileal pouch anal anastomosis. “Surgery has always been an option for patients with UC, but it is often viewed as a last resort,” says Dr. Bewtra. Research shows that elective colectomy is associated with low morbidity and mortality, but it may also alter patients’ QOL following the procedure.   Assessing Survival QOL, morbidity, and mortality are important factors that drive treatment decisions for patients with UC and their physicians. Dr. Bewtra and colleagues had a retrospective study published in Annals of Internal Medicine that looked at whether or not patients with advanced UC had better survival by undergoing elective colectomy or by being treated with medical therapy. “It’s important to clarify if elective surgery for UC can...