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

Duk Hwan Kim, Jae Hee Cheon, Jae Jun Park, Jin Young Yoon, Chang Mo Moon, Sung Pil Hong, Tae Il Kim, Won Ho Kim

Research output: Contribution to journalArticle

6 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)58-65
Number of pages8
JournalGut and liver
Volume7
Issue number1
DOIs
Publication statusPublished - 2013 Jan 1

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Crohn Disease
Adrenal Cortex Hormones
Therapeutics
Steroids
Inflammation

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Kim, Duk Hwan ; Cheon, Jae Hee ; Park, Jae Jun ; Yoon, Jin Young ; Moon, Chang Mo ; Hong, Sung Pil ; Kim, Tae Il ; Kim, Won Ho. / Clinical outcomes and predictive factors for response after the first course of corticosteroid therapy in patients with crohn's disease. In: Gut and liver. 2013 ; Vol. 7, No. 1. pp. 58-65.
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Clinical outcomes and predictive factors for response after the first course of corticosteroid therapy in patients with crohn's disease. / Kim, Duk Hwan; Cheon, Jae Hee; Park, Jae Jun; Yoon, Jin Young; Moon, Chang Mo; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho.

In: Gut and liver, Vol. 7, No. 1, 01.01.2013, p. 58-65.

Research output: Contribution to journalArticle

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AU - Kim, Duk Hwan

AU - Cheon, Jae Hee

AU - Park, Jae Jun

AU - Yoon, Jin Young

AU - Moon, Chang Mo

AU - Hong, Sung Pil

AU - Kim, Tae Il

AU - Kim, Won Ho

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AB - 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.

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