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Corticosteroids early after ulcerative colitis diagnosis predicts severe course of disease

Early corticosteroids requirement after the diagnosis of ulcerative colitis diagnosis can predict a more severe long-term course of the disease, reports August's issue of the Alimentary Pharmacology & Therapeutics.

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

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

The research team obtained nationwide data from the Veterans Affairs (VA) health care system for the period 2001–2011.

Incident ulcerative colitis cases were identified.

A retrospective cohort design and time-to-event survival analysis were used to track outcomes of interest.

The researchers identified 1035 newly diagnosed patients with ulcerative colitis, of whom 23% required early corticosteroids therapy.

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

The research team noted that the 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.

The team found that early corticosteroids users were more likely to require colectomy, and to become corticosteroids dependent than non-users.

Dr Khan and team commented, "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: 40(4): 374–381
23 July 2014

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