| Title | Corticosteroid therapy in ulcerative colitis: Clinical response and predictors |
| Authors | Li, Jin Wang, Fan Zhang, Hong-Jie Sheng, Jian-Qiu Yan, Wen-Feng Ma, Min-Xing Fan, Ru-Ying Gu, Fang Li, Chuan-Feng Chen, Da-Fan Zheng, Ping Gu, Yu-Pei Cao, Qian Yang, Hong Qian, Jia-Ming Hu, Pin-Jin Xia, Bing |
| Affiliation | Wuhan Univ, Zhongnan Hosp, Dept Gastroenterol, Wuhan 430071, Hubei Province, Peoples R China. Hubei Clin Ctr, Wuhan 430071, Hubei Province, Peoples R China. Key Lab Intestinal & Colorectal Dis, Wuhan 430071, Hubei Province, Peoples R China. Nanjing Med Univ, Affiliated Hosp 1, Dept Gastroenterol, Nanjing 210029, Jiangsu, Peoples R China. Mil Gen Hosp Beijing PLA, Dept Gastroenterol, Beijing 100700, Peoples R China. Peking Univ, Affiliated Hosp 3, Dept Gastroenterol, Beijing 100191, Peoples R China. Wuhan Univ, Zhongnan Hosp, Dept Gastroenterol, 169 Donghu Rd, Wuhan 430071, Hubei Province, Peoples R China. |
| Keywords | Clinical response Predictor Corticosteroid Ulcerative colitis INFLAMMATORY-BOWEL-DISEASE CROHNS-DISEASE GLUCOCORTICOID RESISTANCE AZATHIOPRINE FREQUENCY GENETICS EFFICACY ARTICLE ATTACKS COHORT |
| Issue Date | 2015 |
| Publisher | world journal of gastroenterology |
| Citation | WORLD JOURNAL OF GASTROENTEROLOGY.2015,21,(10),3005-3012. |
| Abstract | AIM: To evaluate clinical response to initial corticosteroid (CS) treatment in Chinese ulcerative colitis patients (UC) and identify predictors of clinical response. METHODS: Four hundred and twenty-three UC patients who were initially treated with oral or intravenous CS from 2007 to 2011 were retrospectively reviewed at eight inflammatory bowel disease centers in China, and 101 consecutive cases with one-year follow-up were analyzed further for clinical response and predictors. Short-term outcomes within one month were classified as primary response and primary non-response. Longterm outcomes within one year were classified as prolonged CS response, CS dependence and secondary non-response. CS refractoriness included primary and secondary non-response. Multivariate analyses were performed to identify predictors associated with clinical response. RESULTS: Within one month, 95.0% and 5.0% of the cases were classified into primary response and non-response, respectively. Within one year, 41.6% of cases were assessed as prolonged CS response, while 49.5% as CS dependence and 4.0% as secondary non-response. The rate of CS refractoriness was 8.9%, while the cumulative rate of surgery was 6.9% within one year. After multivariate analysis of all the variables, tenesmus was found to be a negative predictor of CS dependence (OR = 0.336; 95% CI: 0.147-0.768; P = 0.013) and weight loss as a predictor of CS refractoriness (OR = 5.662; 95% CI: 1.111-28.857; P = 0.040). After one-month treatment, sustained high Sutherland score (= 6) also predicted CS dependence (OR = 2.347; 95% CI: 0.935-5.890; P = 0.014). CONCLUSION: Tenesmus was a negative predictor of CS dependence, while weight loss and sustained high Sutherland score were strongly associated with poor CS response. |
| URI | http://hdl.handle.net/20.500.11897/384868 |
| ISSN | 1007-9327 |
| DOI | 10.3748/wjg.v21.i10.3005 |
| Indexed | SCI(E) |
| Appears in Collections: | 第三医院 |
