Natural History of Adult Ulcerative Colitis in Population-based Cohorts: A Systematic Review

Abstract

UC is a disabling condition over time. Prospective cohorts are needed to evaluate the impact of recent strategies of early use of disease-modifying therapies and treat-to-target approach with immunomodulators and biologics. Long-term studies from low-incidence areas are also needed.

Review article: treating‐to‐target for inflammatory bowel disease‐associated anaemia

“…In IBD patients, therapeutic strategies which target control of symptoms do not appear to significantly alter the natural course of the disease as significant end organ damage can accumulate in the absence of symptoms. The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) programme an expert panel made 12 recommendations for treating to target in UC and CD to improve long term outcomes in IBD.…”

The epidemiology of inflammatory bowel disease: East meets west

“…Population-based studies from western populations have shown an increased rate of colorectal cancer (CRC) in UC patients compared to the general population with a pooled standardized incidence ratio (SIR) of 2.4 (95% CI 2.1-2.7). 51 For CD, the reported SIR of CRC ranged from 1.9-3.6. 52,53 In Asia, only few population-based studies have examined the association between IBD and CRC development.…”

Systematic review with network meta‐analysis: first‐ and second‐line pharmacotherapy for moderate‐severe ulcerative colitis

“…Ulcerative colitis affects one in 200‐400 people in Western nations, and its global incidence and prevalence is rising . While the majority of patients have a mild‐moderate course, about 10%‐15% patients experience severe disease course with significant morbidity with frequent flares and hospitalisations, requiring immunosuppressive therapies and corticosteroids, and impose a significant direct and indirect economic burden . Infliximab has conventionally been the mainstay of therapy for moderate‐severe ulcerative colitis, and has been shown to modify the natural history of disease; however, approximately 1/3rd biologic‐naïve patients have primary non‐response to infliximab, and among those who respond, up to 45% lose response over time .…”