Ulcerative Colitis Patients Benefit From Infliximab

The complication rate slowed substantially after the first 2 years. The cumulative rate of a first complication was 43% in the first year after surgery, 68% after 5 years, and 74% after 10 years, said Dr. Akram, a former gastroenterology fellow at the Mayo Clinic in Rochester, Minn. In a cohort study limited to patients who were residents of Olmsted County, Minn., the most common complications were wound infections, small-bowel obstructions, and pouchitis. The type of surgery, usually total proctocolectomy either with ileostomy or with a pouch, was not significantly linked to the complication rate.

In a separate talk at the meeting, Dr. Regueiro said that other complications of colectomy include a substantial reduction in fecundity in young women, impotence in men, other pouch complications, and mortality in a small number of patients (less than 0.5%).

Two drugs have a record for treating advanced UC—infliximab and cyclosporine. The long-term impact of infliximab on UC has not yet been reported, but with cyclosporine about 90% of patients had recurrences within 5 years, including 60% who eventually needed surgery, Dr. Regueiro said.