Short-term and long-term outcomes of acute severe ulcerative colitis in Taiwan: a multicenter study with pre- and post-biologics comparison.
Journal
Intestinal research
Journal Volume
24
Journal Issue
1
Start Page
117
End Page
128
ISSN
1598-9100
Date Issued
2026-01
Author(s)
Lin, Wei-Chen
Lin, Chun-Chi
Hsu, Wen-Hung
Chiang, Feng-Fan
Chang, Chen-Wang
Hsu, Tzu-Chi
Wu, Deng-Chyang
Wang, Horng-Yuan
Abstract
Background/Aims: Data from Asia regarding the short-term and long-term outcomes for acute severe ulcerative colitis (ASUC) are limited. We assessed the outcomes of ASUC, identified the risk factors for colectomy, and compared colectomy rates between the pre-biologics and post-biologics eras in Taiwan. Methods: The patients with an ASUC diagnosis between January 2013 and March 2022 at 5 tertiary medical centers were retrospectively analyzed. Results: In total, 98 patients were enrolled, with 68.4% diagnosed in the post-biologics era. In 78.6% of the ASUC patients initially received intravenous steroid therapy, for which the success rate was 74.1%. As for rescue therapy, 15 patients (93.8%) received biologics and 1 (6.3%) received cyclosporin. Biologics rescue therapy had a 93.3% success rate. One (1%) mortality due to septic shock occurred. The colectomy rate for index ASUC admission was 11.2%. Patients receiving colectomy were predominantly male (P=0.012) and at older age (P=0.016). Higher C-reactive protein (P=0.035), lower albumin (P=0.017), and hemoglobin (P=0.023) levels were associated with colectomy risk. During a median follow-up of 24 months, 13 patients (15.1%) had recurrent ASUC and 23.1% of patients received colectomy. The accumulated colectomy rate at 3 years did not differ between the pre- and post-biologics eras (16.1% vs. 13.4%, P=0.270). Conclusions: This is the first Asian study on ASUC to compare colectomy rates between the pre-biologics and post-biologics eras, revealing no significant difference. The recurrent ASUC had a higher colectomy rate than the index ASUC. (Intest Res 2026;24:117-128).
Subjects
Biologics
Colectomy
Risk factors
Ulcerative colitis
Type
journal article