Biologics prolong remission duration in ulcerative colitis

Among patients with ulcerative colitis (UC), treatment with biologic agents may lead to longer remission durations, a recent study has found. However, biologics appear to have no effect on the risk of resection, particularly in moderate to severe active disease.

Researchers conducted a retrospective analysis of 1,041 patients in whom a total of 1,626 exacerbation events were documented. The study’s co-endpoints were cumulative incidence rates of surgical resection and disease re-exacerbations. Analyses were according to disease severity.

Over a follow-up of 46.3 months, 451 patients relapsed. Of the 1,626 exacerbation episodes, 959 were classified as moderate to severe, most of which were confirmed as disease remission.

Treatment with biologic agents reduced the risk of re-exacerbation by almost 50 percent (hazard ratio [HR], 0.501, 95 percent confidence interval [CI], 0.367–0.684; p<0.001). Meanwhile, use of corticosteroids worsened such risk (HD, 1.473, 95 percent CI, 1.183–1.833; p=0.001), as did having pancolitis UC (HR, 1.217, 95 percent CI, 1.065–1.391; p=0.004).

In contrast, biologics appeared to have no statistical effect on the risk of surgical resection (HR, 0.913, 95 percent CI, 0.556–1.499; p=0.719). For this endpoint, age ≥60 years, severe exacerbations, and the use of calcineurin inhibitors all emerged as significant correlates, all of which more than doubled the risk of resection.

“Our findings indicated the distinctive potential of biologics and the strategic directions of using these drugs in patients,” the researchers said.