Scientific Reports (Dec 2022)

The long-term effect of biologics in patients with ulcerative colitis emerging from a large Japanese cohort

  • Yuya Yokoyama,
  • Yuki Ohta,
  • Sadahisa Ogasawara,
  • Jun Kato,
  • Ryoko Arai,
  • Hirotaka Koseki,
  • Masaya Saito,
  • Tatsuya Kaneko,
  • Mamoru Tokunaga,
  • Hirotaka Oura,
  • Tsubasa Oike,
  • Yushi Imai,
  • Kengo Kanayama,
  • Naoki Akizue,
  • Junichiro Kumagai,
  • Takashi Taida,
  • Kenichiro Okimoto,
  • Keiko Saito,
  • Yoshihiko Ooka,
  • Tomoaki Matsumura,
  • Tomoo Nakagawa,
  • Makoto Arai,
  • Tatsuro Katsuno,
  • Yoshihiro Fukuda,
  • Yoshio Kitsukawa,
  • Naoya Kato

DOI
https://doi.org/10.1038/s41598-022-25218-x
Journal volume & issue
Vol. 12, no. 1
pp. 1 – 11

Abstract

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Abstract To gain a better understanding of the effects of biologics, we evaluated clinical outcomes in patients with moderate to severe exacerbations of ulcerative colitis (UC). This retrospective, multicenter study retrieved the entire clinical courses of UC patients who began treatments between 2004 and 2018. All exacerbations and clinical parameters, including treatment details for exacerbations and both remission and re-exacerbation dates, were identified during the observation period. Two different endpoints, the cumulative incidence rates of surgical resection and re-exacerbation, were evaluated separately in moderate to severe exacerbation events. Among 1401 patients, 1626 exacerbation events were determined according to a partial Mayo score (remission: 7). During the observation period, as administration rates of biologics increased, both surgical resection and hospitalization rates decreased, for 959 moderate to severe exacerbation events. We confirmed that biologics significantly reduced the cumulative re-exacerbation rate in moderate to severe exacerbation events during the study period compared with suboptimal therapies (a 0.507-fold decreased risk according to COX regression analysis, P < 0.001). However, they had not enough impact in reducing the cumulative incidence rate of surgical resection in moderate to severe exacerbation events that were corticosteroid-refractory or dependent (a 0.878-fold decreased risk according to COX regression analysis, P = 0.606). Biologics may improve remission duration, but these agents had no significant impact in reducing the risk of surgical resection in moderate to severe active UC.