Emerging Therapies Reduce Need for Surgery in Ulcerative Colitis Patients

A comprehensive 20-year study indicates that innovative medical treatments are significantly decreasing the necessity for surgical intervention in individuals with ulcerative colitis. Researchers analyzed data from the Lothian IBD Registry, which includes nearly all patients treated within NHS Lothian, revealing notable trends in medication use and surgical rates from 2004 to 2023. During this period, the prevalence of advanced therapies—targeted immune system medicines—rose sharply, leading to a dramatic decline in colectomy procedures, which involve removing the colon. Specifically, the number of surgeries decreased from 42 patients in 2004 to just seven in 2023, coinciding with an increase in prescribed advanced treatments from none to over 115 patients annually.

The study highlights 2013 as a pivotal year when the prescription of these therapies began to rise significantly, corresponding with the downward trend in surgical rates. Among the most utilized drugs since 2021 is filgotinib, an orally administered medication that offers a cost-effective alternative to infusion-based therapies.

The findings suggest a strong association between access to modern treatments and improved patient outcomes, although the researchers clarify that causality cannot be definitively established from this data alone. The study underscores the importance of providing early and equitable access to these therapies to potentially prevent life-altering surgeries. The research was published in "Alimentary Pharmacology & Therapeutics" and involved collaboration between the University of Edinburgh and NHS Lothian.

Professor Charlie Lees from the University of Edinburgh emphasized that wider adoption of targeted drugs could spare many patients from the physical and psychological burdens of surgery, noting that the decline in colectomy rates since 2004 exceeds 80%. The study advocates for further research across regions with varying levels of access to these treatments to better understand their impact on surgical outcomes.

Source: https://medicalxpress.com/news/2025-07-therapies-curb-surgery-ulcerative-colitis.html