Have we reached the top for therapy for IBD?

A recent Danish population cohort study evaluated 48,967 patients with IBD (CD, 13,185 and UC, 35,782) during 1979-2011. The 5-year cumulative probability of the first major surgery decreased from 44.7% in the early cohort (1979-1986) to 19.6% in the later cohort (2003-2011; P less than .001) for Crohn’s disease, and from 11.7% in early cohort to 7.5% in later cohort (P less than .001) for ulcerative colitis.

There are numerous drugs in development with different mechanisms of action for patients with both ulcerative colitis and Crohn’s disease. Too many IBD patients still face surgery, although there has been improvement. We are learning how to better use the medications we have and optimize therapy.

Dr. Lichtenstein is professor of medicine, department of medicine, division of gastroenterology, at the University of Pennsylvania, Philadelphia, and director of the IBD program at the university. His comments were made during the ASGE and AGA joint Presidential Plenary at the annual Digestive Disease Week.