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Master thesis

Recours à la colectomie et impact des traitements dans la rectocolite hémorragique, à l'ère des biothérapies

Abstract : Background & Aims: In the era of biologics, data on the cumulative incidence of colectomy are scarce in patients with ulcerative colitis (UC). The impact of 5-aminosalicylates (5-ASA), azathioprine and anti-tumor necrosis factor (TNF) treatment on the long-term need for surgery is unknown.Methods: This was an observational study of a referral centre cohort. The cumulative incidence of UC-related colectomy was estimated using the Kaplan-Meier method. Independent predictors of surgery were identified using Cox proportional hazards regression with propensity scores adjustment. The electronic charts of 151 incident cases of UC from Nancy University Hospital, France, iagnosedbetween 2000 and 2008, were reviewed through January 2010.Results: The median follow-up time per patient was 58 months. Twenty-one (14 %) underwent surgery. The cumulative probability of colectomy was 13.5 % at 5 years from the time of diagnosis. The probability of receiving oral mesalamine at 5 years was 68.1 %. The corresponding figures were 48.9 % for azathioprine and 29.0 % for infliximab. For corticosteroids, methotrexate and ciclosporin these figures were 75 %, 8.8 %, and 11.5 %, respectively. Using multivariate Cox proportional hazards regression analysis after propensity score adjustment, previous use of ciclosporin was the only independent predictor for colectomy (HR=4.41; 95 % CI 1.75 to 1.13).Conclusions: About one-tenth of patients still require colectomy for UC at 5 years in the era of biologics. Oral 5-ASA, azathioprine and anti-TNF therapy are not associated with reduced need for colectomy
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https://hal.univ-lorraine.fr/hal-01734408
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Nicolas Williet. Recours à la colectomie et impact des traitements dans la rectocolite hémorragique, à l'ère des biothérapies. Sciences du Vivant [q-bio]. 2011. ⟨hal-01734408⟩

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