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Clinical outcomes and predictive factors for response after the first course of corticosteroid therapy in patients with Crohn's disease

Title
 Clinical outcomes and predictive factors for response after the first course of corticosteroid therapy in patients with Crohn's disease 
Authors
 Duk Hwan Kim ; Jae Hee Cheon ; Won Ho Kim ; Tae Il Kim ; Sung Pil Hong ; Chang Mo Moon ; Jin Young Yoon ; Jae Jun Park 
Issue Date
2013
Journal Title
 Gut and Liver 
ISSN
 1976-2283 
Citation
 Gut and Liver, Vol.7(1) : 58~65, 2013 
Abstract
BACKGROUND/AIMS: This study sought to determine the natural course of Crohn's disease (CD) and identify predictors that could indicate responsiveness to corticosteroid (CS) therapy. METHODS: Patients with active CD who were treated with oral CS at a single institution between August 1994 and February 2008 were retrospectively reviewed. The clinical outcomes at 1 month, 4 months, and 1 year after the treatment, as well as clinical and biochemical parameters at the time of CS initiation, were evaluated. RESULTS: A total of 96 patients with CD were enrolled. In this study, 37 patients achieved complete remission (38.5%), 49 achieved partial remission (51.0%), and 10 (10.4%) showed no response at 1 month after the initiation of CS treatment. At 4 months and 1 year after treatment, 66 (69.5%) and 47 (56.6%) patients showed prolonged response, 22 (23.2%) and 20 (24.1%) showed steroid dependency, and 7 (7.4%) and 16 (19.3%) showed refractoriness, respectively. Nonstricturing and nonpenetrating behaviors and a lower CD activity index demonstrated clinical significance for mid-term or mid- and long-term steroid responses, respectively. CONCLUSIONS: The short-term response rate to initial oral CS therapy in CD was considerably high, but responsiveness thereafter showed a tendency to decrease with time. Clinical parameters reflecting mild inflammation were associated with responsiveness after CS treatment.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/86431
DOI
10.5009/gnl.2013.7.1.58
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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