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Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis
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Dynamic changes in clinical response to corticosteroids in ulcerative colitis.
Beatriz Gros1,2,3, Marina Orti Cuerva1, María Auxiliadora Valenzuela García1
1Gastroenterology and Hepatology Department, Reina Sofía University Hospital, University of Cordoba, Cordoba, Spain.
Corticosteroid response in ulcerative colitis (UC) is dynamic; over a third of non-responders persist. Factors like extraintestinal manifestations and disease extent predict better response to UC treatments.
Area of Science:
- Gastroenterology
- Clinical Pharmacology
- Inflammatory Bowel Disease Research
Background:
- Corticosteroids are key for ulcerative colitis (UC) flares.
- Many UC patients lack response or become steroid-dependent.
- The long-term corticosteroid response pattern in UC is not well understood.
Purpose of the Study:
- To analyze the changing dynamics of corticosteroid response in UC patients over multiple treatment courses.
- To identify factors influencing corticosteroid response and non-response in UC.
Main Methods:
- Retrospective cohort study of adult UC patients (1975-2023) receiving ≥2 corticosteroid courses.
- Treatment response assessed via Partial Mayo Score (PMS).
- Markov modeling used to analyze response state transitions and identify associated factors.
Main Results:
- 201 of 571 UC patients met inclusion criteria; 899 corticosteroid courses analyzed.
- 44.3% experienced non-response and 41.8% developed steroid dependence during follow-up.
- Non-response persistence probability was 37.8%, complete response persistence was 79.5%. Enteric infections, beclomethasone use, extraintestinal manifestations, and disease extension were significant factors.
Conclusions:
- Corticosteroid response in UC is a dynamic process, not static.
- A significant proportion of UC patients who initially do not respond remain unresponsive to subsequent courses.
- Extraintestinal manifestations, corticosteroid type (prednisone vs. beclomethasone), and greater disease extension influence corticosteroid response likelihood in UC.
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