P124 The bottom line on ulcerative proctitis: an 11-year analysis of patient outcomes from a UK teaching hospital

Introduction Ulcerative proctitis (UP), is a localized manifestation of ulcerative colitis (UC) confined to the rectum.1 Between 25–55% of patients diagnosed with UC initially present with UP.2Patients with UP exhibit more favourable prognoses compared to those with extensive UC though up to 30% of those with UP progress to more extensive colitis over time.3 This retrospective analysis explores the clinical trajectories of patients with UP referred to a UK teaching hospital over 11 years. Methods This study retrospectively identified patients diagnosed with UP between 2012 and 2023 at a medium-sized UK teaching hospital. Patient data, extracted from electronic health records, were analysed using descriptive statistics. Results We identified 176 patients with UP (56% male), with a median diagnostic age of 56.5 years (IQR, 43–76). The median follow-up period was 3.5 years (IQR, 1–7). At diagnosis, 13.4% (n=23) were active smokers. Endoscopic severity was classified as mild in 67 cases (62.6%) and moderate to severe in 60 (56%) of the 107 patients with available data. As initial management, 41 patients (23.2%) received topical 5-ASA, 85 (48.3%) received oral 5-ASA, 10 (5.6%) received topical steroids, and 27 (15.3%) no treatment. Treatment escalation was required for 30 patients (17.0%), with a median time from diagnosis to escalation of 12 months (IQR, 12–24). 23 patients (13.1%) had azathioprine, and 18 (10.2%) required biologics, with 4 (2.2%) needing second-line biologics. The specific biologics used were infliximab (n=7), vedolizumab (n=6), adalimumab (n=2), golimumab (n=2), and ustekinumab (n=1). Four patients (2.2%) underwent surgical resection. A total of 71 patients (40%) were discharged back to primary care after a median follow-up of 18.5 months (IQR, 8–48), and 3 (1.7%) were referred back to secondary care. Conclusion UP predominantly exhibits a mild clinical course, with a significant proportion of patients responding adequately to first-line therapy. Our findings suggest that patients with stable UP, adequately managed on 5-ASA, could be discharged to primary care after 12–18 months’ follow-up. Future research should focus on identifying predictors of 5-ASA failure in UP. References Satsangi J, Silverberg MS, Vermeire S, et al. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006;55:749–753. Meucci G, Vecchi M, Astegiano M, et al. The natural history of ulcerative proctitis: a multicenter, retrospective study. Am J Gastroenterol 2000;95:469–473. Kim B, Park SJ, Hong SP, et al. Proximal disease extension and related predicting factors in ulcerative proctitis. Scand J Gastroenterol. 2014 Feb;49(2):177–83.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.