Clinical outcomes and predictive factors in oral corticosteroid-refractory active ulcerative colitis

Han Ho Jeon, Hyun Jung Lee, Hui Won Jang, Jin Young Yoon, Yoon Suk Jung, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim, JaeHee Cheon

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

AIM: To evaluate the clinical outcomes and prognostic factors after intravenous corticosteroids following oral corticosteroid failure in active ulcerative colitis patients. METHODS: Consecutive patients with moderate to severe ulcerative colitis who had been treated with a course of intravenous corticosteroids after oral corticosteroid therapy failure between January 1996 and July 2010 were recruited at Severance Hospital, Seoul, South Korea. The disease activity was measured by the Mayo score, which consists of stool frequency, rectal bleeding, mucosal appearance at flexible sigmoidoscopy, and Physician Global Assessment. We retrospectively evaluated clinical outcomes at two weeks, one month, three months, and one year after the initiation of intravenous corticosteroid therapy. Two weeks outcomes were classified as responders or non-responders. One month, three month and one year outcomes were classified into prolonged response, steroid dependency, and refractoriness. RESULTS: Our study included a total of 67 eligible patients. At two weeks, 56 (83.6%) patients responded to intravenous corticosteroids. At one month, complete remission was documented in 18 (32.1%) patients and partial remission in 26 (46.4%). Eleven patients (19.7%) were refractory to the treatment. At three months and one year, we found 37 (67.3%) and 25 (46.3%) patients in prolonged response, ten (18.2%) and 23 (42.6%) patients in corticosteroid dependency, 8 (14.5%) and 6 (11.1%) patients with no response, respectively. Total 9 patients were underwent elective proctocolectomy within 1 year. The duration of oral corticosteroid therapy (> 14 d vs ≤ 14 d, P = 0.049) and lower hemoglobin level (≤ 11.0 mg/dL vs >11.0 mg/ dL, P = 0.02) were found to be poor prognostic factors for response at two weeks. For one year outcome, univariate analysis revealed that only a partial Mayo score (≥ 6 vs <6, P = 0.057) was found to be associated with a poor response. CONCLUSION: The duration of oral corticosteroid therapy and lower hemoglobin level were strongly associated with poor outcome.

Original languageEnglish
Pages (from-to)265-273
Number of pages9
JournalWorld Journal of Gastroenterology
Volume19
Issue number2
DOIs
Publication statusPublished - 2013 Feb 18

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Ulcerative Colitis
Adrenal Cortex Hormones
Hemoglobins
Therapeutics
Sigmoidoscopy
Republic of Korea
Steroids
Hemorrhage
Physicians

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Jeon, Han Ho ; Lee, Hyun Jung ; Jang, Hui Won ; Yoon, Jin Young ; Jung, Yoon Suk ; Park, Soo Jung ; Hong, Sung Pil ; Kim, Tae Il ; Kim, Won Ho ; Cheon, JaeHee. / Clinical outcomes and predictive factors in oral corticosteroid-refractory active ulcerative colitis. In: World Journal of Gastroenterology. 2013 ; Vol. 19, No. 2. pp. 265-273.
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abstract = "AIM: To evaluate the clinical outcomes and prognostic factors after intravenous corticosteroids following oral corticosteroid failure in active ulcerative colitis patients. METHODS: Consecutive patients with moderate to severe ulcerative colitis who had been treated with a course of intravenous corticosteroids after oral corticosteroid therapy failure between January 1996 and July 2010 were recruited at Severance Hospital, Seoul, South Korea. The disease activity was measured by the Mayo score, which consists of stool frequency, rectal bleeding, mucosal appearance at flexible sigmoidoscopy, and Physician Global Assessment. We retrospectively evaluated clinical outcomes at two weeks, one month, three months, and one year after the initiation of intravenous corticosteroid therapy. Two weeks outcomes were classified as responders or non-responders. One month, three month and one year outcomes were classified into prolonged response, steroid dependency, and refractoriness. RESULTS: Our study included a total of 67 eligible patients. At two weeks, 56 (83.6{\%}) patients responded to intravenous corticosteroids. At one month, complete remission was documented in 18 (32.1{\%}) patients and partial remission in 26 (46.4{\%}). Eleven patients (19.7{\%}) were refractory to the treatment. At three months and one year, we found 37 (67.3{\%}) and 25 (46.3{\%}) patients in prolonged response, ten (18.2{\%}) and 23 (42.6{\%}) patients in corticosteroid dependency, 8 (14.5{\%}) and 6 (11.1{\%}) patients with no response, respectively. Total 9 patients were underwent elective proctocolectomy within 1 year. The duration of oral corticosteroid therapy (> 14 d vs ≤ 14 d, P = 0.049) and lower hemoglobin level (≤ 11.0 mg/dL vs >11.0 mg/ dL, P = 0.02) were found to be poor prognostic factors for response at two weeks. For one year outcome, univariate analysis revealed that only a partial Mayo score (≥ 6 vs <6, P = 0.057) was found to be associated with a poor response. CONCLUSION: The duration of oral corticosteroid therapy and lower hemoglobin level were strongly associated with poor outcome.",
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Jeon, HH, Lee, HJ, Jang, HW, Yoon, JY, Jung, YS, Park, SJ, Hong, SP, Kim, TI, Kim, WH & Cheon, J 2013, 'Clinical outcomes and predictive factors in oral corticosteroid-refractory active ulcerative colitis', World Journal of Gastroenterology, vol. 19, no. 2, pp. 265-273. https://doi.org/10.3748/wjg.v19.i2.265

Clinical outcomes and predictive factors in oral corticosteroid-refractory active ulcerative colitis. / Jeon, Han Ho; Lee, Hyun Jung; Jang, Hui Won; Yoon, Jin Young; Jung, Yoon Suk; Park, Soo Jung; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho; Cheon, JaeHee.

In: World Journal of Gastroenterology, Vol. 19, No. 2, 18.02.2013, p. 265-273.

Research output: Contribution to journalArticle

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T1 - Clinical outcomes and predictive factors in oral corticosteroid-refractory active ulcerative colitis

AU - Jeon, Han Ho

AU - Lee, Hyun Jung

AU - Jang, Hui Won

AU - Yoon, Jin Young

AU - Jung, Yoon Suk

AU - Park, Soo Jung

AU - Hong, Sung Pil

AU - Kim, Tae Il

AU - Kim, Won Ho

AU - Cheon, JaeHee

PY - 2013/2/18

Y1 - 2013/2/18

N2 - AIM: To evaluate the clinical outcomes and prognostic factors after intravenous corticosteroids following oral corticosteroid failure in active ulcerative colitis patients. METHODS: Consecutive patients with moderate to severe ulcerative colitis who had been treated with a course of intravenous corticosteroids after oral corticosteroid therapy failure between January 1996 and July 2010 were recruited at Severance Hospital, Seoul, South Korea. The disease activity was measured by the Mayo score, which consists of stool frequency, rectal bleeding, mucosal appearance at flexible sigmoidoscopy, and Physician Global Assessment. We retrospectively evaluated clinical outcomes at two weeks, one month, three months, and one year after the initiation of intravenous corticosteroid therapy. Two weeks outcomes were classified as responders or non-responders. One month, three month and one year outcomes were classified into prolonged response, steroid dependency, and refractoriness. RESULTS: Our study included a total of 67 eligible patients. At two weeks, 56 (83.6%) patients responded to intravenous corticosteroids. At one month, complete remission was documented in 18 (32.1%) patients and partial remission in 26 (46.4%). Eleven patients (19.7%) were refractory to the treatment. At three months and one year, we found 37 (67.3%) and 25 (46.3%) patients in prolonged response, ten (18.2%) and 23 (42.6%) patients in corticosteroid dependency, 8 (14.5%) and 6 (11.1%) patients with no response, respectively. Total 9 patients were underwent elective proctocolectomy within 1 year. The duration of oral corticosteroid therapy (> 14 d vs ≤ 14 d, P = 0.049) and lower hemoglobin level (≤ 11.0 mg/dL vs >11.0 mg/ dL, P = 0.02) were found to be poor prognostic factors for response at two weeks. For one year outcome, univariate analysis revealed that only a partial Mayo score (≥ 6 vs <6, P = 0.057) was found to be associated with a poor response. CONCLUSION: The duration of oral corticosteroid therapy and lower hemoglobin level were strongly associated with poor outcome.

AB - AIM: To evaluate the clinical outcomes and prognostic factors after intravenous corticosteroids following oral corticosteroid failure in active ulcerative colitis patients. METHODS: Consecutive patients with moderate to severe ulcerative colitis who had been treated with a course of intravenous corticosteroids after oral corticosteroid therapy failure between January 1996 and July 2010 were recruited at Severance Hospital, Seoul, South Korea. The disease activity was measured by the Mayo score, which consists of stool frequency, rectal bleeding, mucosal appearance at flexible sigmoidoscopy, and Physician Global Assessment. We retrospectively evaluated clinical outcomes at two weeks, one month, three months, and one year after the initiation of intravenous corticosteroid therapy. Two weeks outcomes were classified as responders or non-responders. One month, three month and one year outcomes were classified into prolonged response, steroid dependency, and refractoriness. RESULTS: Our study included a total of 67 eligible patients. At two weeks, 56 (83.6%) patients responded to intravenous corticosteroids. At one month, complete remission was documented in 18 (32.1%) patients and partial remission in 26 (46.4%). Eleven patients (19.7%) were refractory to the treatment. At three months and one year, we found 37 (67.3%) and 25 (46.3%) patients in prolonged response, ten (18.2%) and 23 (42.6%) patients in corticosteroid dependency, 8 (14.5%) and 6 (11.1%) patients with no response, respectively. Total 9 patients were underwent elective proctocolectomy within 1 year. The duration of oral corticosteroid therapy (> 14 d vs ≤ 14 d, P = 0.049) and lower hemoglobin level (≤ 11.0 mg/dL vs >11.0 mg/ dL, P = 0.02) were found to be poor prognostic factors for response at two weeks. For one year outcome, univariate analysis revealed that only a partial Mayo score (≥ 6 vs <6, P = 0.057) was found to be associated with a poor response. CONCLUSION: The duration of oral corticosteroid therapy and lower hemoglobin level were strongly associated with poor outcome.

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