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Early corticosteroids requirement predict a more severe course of ulcerative colitis

Early corticosteroids requirement after the diagnosis of ulcerative colitis diagnosis can predict a more severe long-term course of the disease, reports a study in the Alimentary Pharmacology & Therapeutics published ahead of print.

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There are limited data regarding clinical outcomes in ulcerative colitis patients who require early corticosteroids use.

Dr Khan and colleagues evaluated the rate of early corticosteroids utilization as a predictive marker for long-term outcomes, colectomy and corticosteroids dependency, in a population-based cohort of incident ulcerative colitis cases.

Nationwide data were obtained from the Veterans Affairs (VA) health care system for the period 20012011.

The researchers identified incident ulcerative colitis cases.

The team performed a retrospective cohort study, and performed a time-to-event survival analysis to track outcomes of interest.

The research team identified 1035 newly diagnosed patients with ulcerative colitis, and included in the analysis.

23% of those patients required early corticosteroids therapy
Alimentary Pharmacology & Therapeutics

The team noted that 23% of those patients required early corticosteroids therapy.

Patients were followed-up over a median time of 5 years after ulcerative colitis diagnosis.

The research team found that 5-year cumulative probability of requiring colectomy varied significantly by early corticosteroids use status.

Similar variation in the 5-year cumulative probability of corticosteroids dependency by early corticosteroids status was observed.

Early corticosteroids users were more likely to require colectomy, and to become corticosteroids dependent than non-users.

Dr Khan's team comments, "Early corticosteroids use can help identify those patients who have a more active disease course of ulcerative colitis."

"Recognizing this can be among the indicators that can help physicians identify patients who may require early initiation of more aggressive therapy."

Aliment Pharmacol & Ther 2014: Early View
14 July 2014

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