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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 
Citation
 Gut and Liver, Vol.7(1) : 58~65, 2013 
Journal Title
 Gut and Liver 
ISSN
 1976-2283 
Issue Date
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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