Letter: Surgery for ulcerative colitis mostly follows anti-TNF drugs - A new 'therapeutic package'? Authors' reply

摘要

Sirs, First of all, we thank Drs Barreiro de Costa and Gisbert for their positive and constructive comments regarding our study.We have to emphasise that during our study period only 16.2 percent (199/1226) of ulcerative colitis (UC) patients having colectomy were treated with anti-tumour necrosis factor-alpha (TNF-alpha) within 12 weeks of surgery. As stated in the commentary, we found a progressive increase by calendar period in the use of anti-TNF-alpha before colectomy. Thus, among exposed patients (those having anti-TNF-alpha within 12 weeks before surgery) 10.6 percent (21/ 199) received anti-TNF-a before 2007, whereas the vast majority (178/199 = 89.4 percent ) received anti-TNF-a at the end of the study period from 2007 through 2010. In the future, it will be very interesting to follow the use of pre-operative anti-TNF-a treatment in patients with UC; and as stated in the letter, we will expect to find increasing number of patients treated before colec-tomy with a broader spectrum of indications.