The investigators assessed the effect of corticosteroid pulse therapy (the use of supraphysiologic dose followed by complete withdrawal) in patients with moderate to severe ulcerative colitis (UC).
The findings of the trial were reported in the October issue of the Journal of Clinical Gastroenterology.
Dexamethasone pulse therapy (100 mg/d infusion in 5% dextrose) was used for 3 consecutive days in 14 patients with severe UC.
UC disease activity was assessed on days 7, 15, 30, and 60.
The researchers defined the primary end point as the number of patients who achieved clinical remission and an activity index less than 150 at day 15.
| Dexamethasone pulse therapy induced remission in 93% of UC patients at day 15.
| Journal of Clinical Gastroenterology |
The second end point was the number of patients who remained in remission and had an activity index less than 150 at 30 and 60 days.
None of the patients enrolled got subsequent oral corticosteroids after their 3 days of megadose corticosteroid infusion.
It was found that clinical remission was achieved in 93% patients by day 15.
However, 15% of these patients suffered relapse during follow-up.
Hence, the clinical remission was sustained in 79% patients at 30 and 60 days.
Dr Ajit Sood, of the Dayanand Medical College and Hospital, Ludhiana, Punjab, said on behalf of fellow colleagues, "Dexamethasone pulse therapy is highly effective in inducing remission in patients with UC."
"However, randomized controlled trials are needed to compare dexamethasone pulse therapy with standard oral continuous corticosteroid regimens," it was concluded.