As a Crohn’s patient one thing I always wonder/worry about is whether or not I will get a stoma. New research shows that in the era of post-biologics the rate of stomas has decreased by 33%. Maurizio Coscia and his colleagues looked at 51 patients to determine who underwent a colectomy between 1995 and 2002 and then 182 patients who had abdominal surgery after 2002. 2002 is seen as the year post biologics however one could argue with this given Humira wasn’t approved for Crohn’s until 2007. Cimiza another biologic wasn’t approved until 2008. Remicade was really the only drug that was approved for use before 2002 (approved in 1998). So really you can argue that the future rates might be even lower given more entrants into the Crohn’s market. Personally I believe the new treatments for Crohn’s will be as effective as biologics with less side effects (TSO whipworms) being one of these.
I have actually blogged about this before in a Saturday Study series. Dr. Fabrizio Michelassi did a study while he was at the University of Chicago (he is now at Cornell) and found that only 7% of patients needed a permanent stoma. The time period studied was 1970 through 1998.
With more time, surgeries performed, and research performed I believe the rate of stomas will decrease which is positive. Hopefully more novel treatments will come out in order to better treat Crohn’s and ulcerative colitis. Doctors are always remarking how they never would have imagined the current treatments for IBD. Hopefully the future will have an unexpected way of arriving.