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We read with great interest the systematic review by Honap et al1 and commend the authors for highlighting the elevated risk of colectomy in patients with acute severe UC. While there is ample knowledge about colectomy as a last resort treatment in UC,2 little is known about the colectomy risk in microscopic colitis (MC).3–6 As the incidence of MC has been on the rise over the past decades,7 with current incidence rates (IRs) rivalling those of UC and Crohn’s disease,8 knowledge on the risk of colectomy in patients with MC is warranted.
Leveraging the nationwide Swedish ESPRESSO histopathology cohort,9 we estimated the risk of colectomy in patients with biopsy-verified MC (diagnosed 1990–2017) compared with matched reference individuals from the general population (matched by age, sex, county of residence and calendar year). Colectomy was defined as having a corresponding surgical procedure code indicating total colectomy recorded in the National Patient Register (online supplemental table S1).
Supplemental material
Follow-up began on the date of MC diagnosis (any of the subtypes of collagenous colitis or lymphocytic colitis) and on the matching date for the reference individuals. Study participants were followed until 31 December 2021 for colectomy, death, emigration or a medical …
Footnotes
Contributors Guarantors: DB and JFL had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: all authors. Acquisition of data: JFL. Analysis: DB. Interpretation of data: All authors. Writing the first draft of the manuscript: DB.
Funding This work was supported by the Karolinska Institutet (JFL), Stockholm County Council (JFL), the NIH (National Institutes of Health NIA R01 (AG068390; JFL). The European Crohn's and Colitis Organization (JS). Bengt Ihre Research Fellowship (AF). Swiss National Science Foundation: P500PM_210866 (FE). None of the funding organisations has had any role in the design and conduct of the study, in the collection, management and analysis of the data or in the preparation, review and approval of the manuscript.
Competing interests JFL has coordinated a study on behalf of the Swedish IBD Quality Register (SWIBREG). That study received funding from the Janssen Corporation. JFL has also received financial support from MSD to develop a paper reviewing national healthcare registers in China and has a collaboration on the coeliac disease with Takeda. FE has served as an advisory board member for Boehringer Ingelheim. AF has served as an advisory board member and speaker for Janssen Cilag AB and Tillotts Pharma.
Provenance and peer review Not commissioned; internally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.