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Dr Nicole Gentile and colleagues evaluated the outcomes of corticosteroid-treated microscopic colitis in a population-based cohort, and compared these outcomes in patients treated with prednisone or budesonide. A historical cohort study of Olmsted County, Minnesota residents diagnosed with collagenous or lymphocytic colitis between 1986 and 2010 was performed using the Rochester Epidemiology Project. The researchers noted that of 315 patients with microscopic colitis, 80 were treated with corticosteroids. The median age at colitis diagnosis was 67 years, and 78% were female. The researchers noted that 40 patients had lymphocytic colitis, and 40 had collagenous colitis. Prednisone was used in 17 patients and budesonide in 63, and 56 had complete response and 15 had partial response.  | | 50 of 71 patients who responded had a recurrence after corticosteroid discontinuation | | The American Journal of Gastroenterology |
The doctors assessd that patients treated with budesonide had a higher rate of complete response than those treated with prednisone. The research team reported that 6 patients were lost to follow-up. The remaining 74 had a median follow-up of 4 years. The research team noted that 50 patients out of the 71 who responded had a recurrence after corticosteroid discontinuation. Patients treated with budesonide were less likely to recur than those treated with prednisone. The doctors assessed that after 397 person years of follow-up in the 73 patients with long-term data, 47 required maintenance with corticosteroids. Dr Gentile's team concluded, "Patients with microscopic colitis often respond to corticosteroid therapy, but with a high relapse rate." "Budesonide had a higher response rate and a lower risk of recurrence than prednisone."
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