ArticleBMJ open gastroenterology2025
Temporal trends in surgical treatment of inflammatory bowel disease following introduction of biological drugs in Norway and Sweden.
Article in BMJ open gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Essential Updates in the Surgical Management of Inflammatory Bowel Disease: Current Topics From 2024 to Mid-2026.Annals of gastroenterological surgery · 2026Review
- Long-term risk of bowel resection and mortality associated with sleep behaviours and sleep pattern in patients with inflammatory bowel disease: a large-scale prospective cohort study.Family medicine and community health · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe advent of biological drugs has revolutionised management of inflammatory bowel disease (IBD). However, the extent to which these novel pharmacological drugs have reduced the need for surgical treatment remains incompletely quantified.We aimed to investigate the risk of first, major surgery in IBD in a population-based, large epidemiological study.
methodsWe empanelled a cohort comprising all 85 974 patients diagnosed with ulcerative colitis (UC) and 42 760 with Crohn's disease (CD) in Norway and Sweden in 1987 through 2017. We used log-rank tests to compare the cumulative probability of surgical treatment for UC and CD. Using multivariable Cox proportional hazards models, we estimated hazard ratios (HR) with 95% CIs by year of diagnosis, age, sex and extent of disease.
resultsDuring a mean follow-up of 9.9 years, surgery was undertaken in 11 187 (13.0%) patients with UC (12.3 per 1000 person-years) and in 11 307 (26.4%) patients with CD (30.0 per 1000 person-years). In UC, the cumulative 5-year probability of surgery decreased from 16.2% in patients diagnosed in 1987-1994 to 5.8% in those diagnosed in 2011-2017 (p<0.001). In CD, the corresponding decline was from 30.1% to 13.9% (p<0.001). In multivariable analyses, the likelihood of surgical treatment decreased during the study period by 61% (HR 0.39, 95% CI 0.36 to 0.42) in UC and by 31% (HR 0.69, 95% CI 0.65 to 0.75) in CD.
conclusionsFollowing the introduction of biologic drugs, the need for surgical treatments has been dramatically reduced in patients with UC and moderately reduced in patients with CD.
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