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Clinical outcomes and factors for response prediction after the first course of corticosteroid therapy in patients with active ulcerative colitis

Authors
 Jin Young Yoon  ;  Jae Hee Cheon  ;  Jae Jun Park  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Won Ho Kim 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.26(7) : 1114-1122, 2011 
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 0815-9319 
Issue Date
2011
MeSH
Adolescent ; Adult ; Aged ; Child ; Colitis,Ulcerative/diagnosis ; Colitis,Ulcerative/drugtherapy* ; Colonoscopy ; Disease Progression ; Dose-ResponseRelationship, Drug ; Drug Administration Routes ; Female ; Follow-Up Studies ; Glucocorticoids/administration & dosage ; Glucocorticoids/therapeutic use* ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; TimeFactors ; Young Adult
Keywords
clinical outcome ; corticosteroid ; Mayo score ; ulcerative colitis
Abstract
BACKGROUND AND AIMS: Both clinical outcomes and factors predictive for poor response after an initial course of corticosteroids have not yet been well established in the treatment of moderate to severe ulcerative colitis (UC). We therefore evaluated the short- and long-term effects of corticosteroids and prognostic factors in UC patients after such therapy.

METHODS: We recruited consecutive patients who had moderate to severe UC and were treated with the first course of systemic corticosteroids between November 1996 and December 2007 using the database of Severance Hospital in Seoul, Korea. We then evaluated clinical outcomes at 1 month, 3 months, and 1 year after the initiation of corticosteroid treatment.

RESULTS: Our study included a total of 177 patients. At 1 month, complete remission was achieved in 70 patients (39.5%) and partial remission in 88 (49.7%). Fifteen patients (8.5%) were refractory to the treatment, and four (2.3%) underwent proctocolectomy. We observed prolonged response in 111 (64.9%) at 3 months and 95 (59.4%) patients at 1 year, corticosteroid dependency in 49 (28.7%) and 51 (31.9%) patients, and no response in 11 (6.4%) and 14 (8.7%) patients. A higher initial Mayo score was found to be the only poor prognostic factor at 1 month (P = 0.032) and 1 year (P < 0.001).

CONCLUSIONS: Our data showed that most Korean patients with active UC responded well to the first course of corticosteroid treatment. However, a considerable number of patients eventually turned out to be refractory to or dependent on this therapy. The initial higher Mayo score was strongly associated with poor outcomes.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06688.x/abstract
DOI
10.1111/j.1440-1746.2011.06688.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Park, Jae Jun(박재준)
Yoon, Jin Young(윤진영)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94303
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