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Decreasing Colectomy Rate for Ulcerative Colitis in the United States Between 2007 and 2016: A Time Trend Analysis.

Publication ,  Journal Article
Barnes, EL; Jiang, Y; Kappelman, MD; Long, MD; Sandler, RS; Kinlaw, AC; Herfarth, HH
Published in: Inflammatory bowel diseases
July 2020

Improved treatment approaches for ulcerative colitis (UC), including novel medications, might reduce the need for colectomy. We performed a retrospective cohort study of adult patients (age 18-64) with UC in the United States to examine time trends for colectomy and biologic use from 2007 to 2016.We estimated quarterly rates for colectomy and biologic use using the IQVIA Legacy PharMetrics Adjudicated Claims Database. We used interrupted time series methods with segmented regression to assess time trends with 95% confidence intervals (CIs) for biologic use and colectomy before and after the emergence of newly available biologic therapies in 2014.Among 93,930 patients with UC, 2275 (2.4%) underwent colectomy from 2007 to 2016. Biologic use rates increased significantly from 2007 to 2016, from 131 per 1000 person-years in 2007 (95% CI, 121 to 140) to 589 per 1000 person-years in 2016 (95% CI, 575 to 604; P < 0.001). Colectomy rates decreased significantly between 2007 and 2016, from 7.8 per 1000 person-years (95% CI, 7.4 to 8.2) to 4.2 per 1000 person-years in 2016 (95% CI, 3.2 to 5.1; P < 0.001). An interruption in 2014 was associated with a positive trend deflection for biologic use (+72 treatments per 1000 person-years per year (95% CI, 61 to 83) and a negative trend deflection for colectomy (-0.76 per 1000 person-years per year; 95% CI, -1.47 to -0.05).Among commercially insured patients in the United States from 2007 to 2016, biologic use rates increased, colectomy rates decreased, and both trends were impacted by the interruption in 2014. These findings suggest that new biologic therapies may have contributed to decreased colectomy rates.

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Published In

Inflammatory bowel diseases

DOI

EISSN

1536-4844

ISSN

1078-0998

Publication Date

July 2020

Volume

26

Issue

8

Start / End Page

1225 / 1231

Related Subject Headings

  • Young Adult
  • United States
  • Retrospective Studies
  • Middle Aged
  • Male
  • Interrupted Time Series Analysis
  • Humans
  • Gastroenterology & Hepatology
  • Colitis, Ulcerative
  • Colectomy
 

Citation

APA
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ICMJE
MLA
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Barnes, E. L., Jiang, Y., Kappelman, M. D., Long, M. D., Sandler, R. S., Kinlaw, A. C., & Herfarth, H. H. (2020). Decreasing Colectomy Rate for Ulcerative Colitis in the United States Between 2007 and 2016: A Time Trend Analysis. Inflammatory Bowel Diseases, 26(8), 1225–1231. https://doi.org/10.1093/ibd/izz247
Barnes, Edward L., Yue Jiang, Michael D. Kappelman, Millie D. Long, Robert S. Sandler, Alan C. Kinlaw, and Hans H. Herfarth. “Decreasing Colectomy Rate for Ulcerative Colitis in the United States Between 2007 and 2016: A Time Trend Analysis.Inflammatory Bowel Diseases 26, no. 8 (July 2020): 1225–31. https://doi.org/10.1093/ibd/izz247.
Barnes EL, Jiang Y, Kappelman MD, Long MD, Sandler RS, Kinlaw AC, et al. Decreasing Colectomy Rate for Ulcerative Colitis in the United States Between 2007 and 2016: A Time Trend Analysis. Inflammatory bowel diseases. 2020 Jul;26(8):1225–31.
Barnes, Edward L., et al. “Decreasing Colectomy Rate for Ulcerative Colitis in the United States Between 2007 and 2016: A Time Trend Analysis.Inflammatory Bowel Diseases, vol. 26, no. 8, July 2020, pp. 1225–31. Epmc, doi:10.1093/ibd/izz247.
Barnes EL, Jiang Y, Kappelman MD, Long MD, Sandler RS, Kinlaw AC, Herfarth HH. Decreasing Colectomy Rate for Ulcerative Colitis in the United States Between 2007 and 2016: A Time Trend Analysis. Inflammatory bowel diseases. 2020 Jul;26(8):1225–1231.
Journal cover image

Published In

Inflammatory bowel diseases

DOI

EISSN

1536-4844

ISSN

1078-0998

Publication Date

July 2020

Volume

26

Issue

8

Start / End Page

1225 / 1231

Related Subject Headings

  • Young Adult
  • United States
  • Retrospective Studies
  • Middle Aged
  • Male
  • Interrupted Time Series Analysis
  • Humans
  • Gastroenterology & Hepatology
  • Colitis, Ulcerative
  • Colectomy