Treatment-Free Outcomes Following Surgery for IBD : A Nationwide Cohort Study
(2025) In Alimentary Pharmacology and Therapeutics p.1-17- Abstract
Background: Surgery in select individuals with inflammatory bowel disease (IBD) may obviate the need for future IBD-related treatment. Aims: To characterise individuals who remain treatment-free during the first 5 years after initial IBD-related surgery. Methods: We performed a nationwide cohort study using the Swedish National Patient Register and the ESPRESSO histopathology to identify individuals undergoing first IBD-related intestinal resection for Crohn's disease (CD) or total colectomy for ulcerative colitis (UC) between 2007 and 2018. We calculated adjusted odds ratios (aORs) for the need for any IBD-related therapy within the first 5 years post surgery. Results: We included 1709 individuals with CD and 1010 with UC. At 5 years,... (More)
Background: Surgery in select individuals with inflammatory bowel disease (IBD) may obviate the need for future IBD-related treatment. Aims: To characterise individuals who remain treatment-free during the first 5 years after initial IBD-related surgery. Methods: We performed a nationwide cohort study using the Swedish National Patient Register and the ESPRESSO histopathology to identify individuals undergoing first IBD-related intestinal resection for Crohn's disease (CD) or total colectomy for ulcerative colitis (UC) between 2007 and 2018. We calculated adjusted odds ratios (aORs) for the need for any IBD-related therapy within the first 5 years post surgery. Results: We included 1709 individuals with CD and 1010 with UC. At 5 years, 21.5% with CD and 42.4% with UC remained ‘treatment free’. Being ‘treatment free’ 5 years after surgery was more common among patients with CD who had longer preoperative disease duration and older adults with UC. It was less common among individuals with extraintestinal manifestations of disease (CD aOR 0.64, 95% CI 0.43–0.97; UC aOR 0.48, 95% CI 0.31–0.73) and patients with CD who had chronic obstructive pulmonary disease. Conclusions: Surgery obviated the need for future therapy in 22% of patients with CD and 42% with UC. Absence of extraintestinal manifestations, older age in UC, and longer disease duration and absence of chronic obstructive pulmonary disease in CD may highlight an opportunity for precision surgery to identify those most likely to achieve long-term benefit from surgical intervention.
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- author
- Faye, Adam S. ; Axelrad, Jordan ; Sun, Jiangwei ; Halfvarsson, Jonas ; Myrelid, Par ; Söderling, Jonas ; Olén, Ola and Ludvigsson, Jonas F.
- contributor
- Grip, Olof LU
- author collaboration
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- epub
- keywords
- Crohn's disease, inflammatory bowel disease, surgery, ulcerative colitis
- in
- Alimentary Pharmacology and Therapeutics
- pages
- 1 - 17
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- scopus:105021320849
- pmid:41121721
- ISSN
- 0269-2813
- DOI
- 10.1111/apt.70432
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2025 John Wiley & Sons Ltd.
- id
- 3e523202-6f4c-4e95-88a9-ec8e58179117
- date added to LUP
- 2026-02-03 15:55:29
- date last changed
- 2026-02-04 08:14:24
@article{3e523202-6f4c-4e95-88a9-ec8e58179117,
abstract = {{<p>Background: Surgery in select individuals with inflammatory bowel disease (IBD) may obviate the need for future IBD-related treatment. Aims: To characterise individuals who remain treatment-free during the first 5 years after initial IBD-related surgery. Methods: We performed a nationwide cohort study using the Swedish National Patient Register and the ESPRESSO histopathology to identify individuals undergoing first IBD-related intestinal resection for Crohn's disease (CD) or total colectomy for ulcerative colitis (UC) between 2007 and 2018. We calculated adjusted odds ratios (aORs) for the need for any IBD-related therapy within the first 5 years post surgery. Results: We included 1709 individuals with CD and 1010 with UC. At 5 years, 21.5% with CD and 42.4% with UC remained ‘treatment free’. Being ‘treatment free’ 5 years after surgery was more common among patients with CD who had longer preoperative disease duration and older adults with UC. It was less common among individuals with extraintestinal manifestations of disease (CD aOR 0.64, 95% CI 0.43–0.97; UC aOR 0.48, 95% CI 0.31–0.73) and patients with CD who had chronic obstructive pulmonary disease. Conclusions: Surgery obviated the need for future therapy in 22% of patients with CD and 42% with UC. Absence of extraintestinal manifestations, older age in UC, and longer disease duration and absence of chronic obstructive pulmonary disease in CD may highlight an opportunity for precision surgery to identify those most likely to achieve long-term benefit from surgical intervention.</p>}},
author = {{Faye, Adam S. and Axelrad, Jordan and Sun, Jiangwei and Halfvarsson, Jonas and Myrelid, Par and Söderling, Jonas and Olén, Ola and Ludvigsson, Jonas F.}},
issn = {{0269-2813}},
keywords = {{Crohn's disease; inflammatory bowel disease; surgery; ulcerative colitis}},
language = {{eng}},
pages = {{1--17}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Alimentary Pharmacology and Therapeutics}},
title = {{Treatment-Free Outcomes Following Surgery for IBD : A Nationwide Cohort Study}},
url = {{http://dx.doi.org/10.1111/apt.70432}},
doi = {{10.1111/apt.70432}},
year = {{2025}},
}