title: Long-term prognosis of ulcerative colitis and its temporal change between 1977 and 2013: a hospital-based cohort study from Korea.
abstract: OBJECTIVE
  No previous large-scale studies have evaluated the prognosis of ulcerative colitis (UC) over a period of three decades in a non-Caucasian population. The aims of this study were to update the current information on the natural course of UC in a sizable cohort of Korean patients and to evaluate changes in the treatment paradigms and prognosis of UC over time.
  
  
  METHODS
  We retrospectively analyzed 2802 Korean UC patients who visited Asan Medical Center. We divided the study subjects into three groups based on the year of diagnosis (cohort 1: 1977–1999; cohort 2: 2000–2006; and cohort 3: 2007–2013).
  
  
  RESULTS
  Five-year cumulative probabilities of prescription of thiopurines (azathioprine or 6-mercaptopurine) and anti-tumor necrosis factor (anti-TNF) agents were 4.1% and 0.0%, respectively, in cohort 1 and 27.9% and 12.7%, respectively, in cohort 3 (P < 0.001). A total of 209 patients (7.5%) underwent colectomy, producing cumulative probabilities of colectomy at 10, 20 and 30 years after diagnosis of 7.8%, 14.2% and 21.3%, respectively. The cumulative probability of colectomy was especially low in patients first diagnosed at our center: 3.1% at 10 years and 4.5% at 20 years. Moreover, the cumulative probability of colectomy decreased significantly over the last 30 years (P = 0.039).
  
  
  CONCLUSIONS
  Thiopurines and anti-TNF agents are used increasingly more frequently and earlier, while the colectomy rate has decreased over the last 30 years in Korean patients with UC. Korean UC patients may have a better clinical course than Western cases, as indicated by a lower colectomy rate.
authors.forename: Ho-Su
authors.initials: HS
authors.lastname: Lee
authors.forename: Sang Hyoung
authors.initials: SH
authors.lastname: Park
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Jungbok
authors.initials: J
authors.lastname: Lee
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Soh
authors.forename: Seohyun
authors.initials: S
authors.lastname: Lee
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Hyo Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Yang
authors.forename: Kyung-Jo
authors.initials: KJ
authors.lastname: Kim
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Yea
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Yoon
authors.forename: Chang Sik
authors.initials: CS
authors.lastname: Yu
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D019468:Disease Management; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents