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Corticosteroid therapy in ulcerative colitis: Clinical response and predictors
Jin Li1, Fan Wang1, Hong-Jie Zhang1
1Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
World Journal of Gastroenterology
|March 18, 2015
Summary
In Chinese ulcerative colitis patients, initial corticosteroid treatment showed high short-term response rates. However, predictors like tenesmus, weight loss, and high Sutherland scores indicated potential for dependence or refractoriness to corticosteroids.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Pharmacology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Corticosteroids (CS) are a cornerstone of initial UC treatment.
- Predicting response to CS is crucial for optimizing patient management.
Purpose of the Study:
- To assess clinical response to initial corticosteroid therapy in Chinese UC patients.
- To identify predictors associated with short-term and long-term CS response.
- To understand factors influencing CS dependence and refractoriness.
Main Methods:
- Retrospective review of 423 UC patients treated with CS (2007-2011).
- Detailed analysis of 101 patients with one-year follow-up for clinical response.
- Multivariate analyses to identify predictors of CS response and refractoriness.
Main Results:
- 95% primary response within one month; 41.6% prolonged CS response within one year.
- 49.5% CS dependence and 8.9% CS refractoriness observed.
- Tenesmus predicted lower CS dependence; weight loss and high Sutherland score predicted poor CS response.
Conclusions:
- Initial CS treatment is effective short-term for most Chinese UC patients.
- Predictors such as tenesmus, weight loss, and high Sutherland scores can indicate poor long-term outcomes.
- Identifying these predictors aids in tailoring UC management strategies.
