Corticosteroids remain the mainstay of first-line therapy in active inflammatory bowel disease (IBD).
Dr Ho and colleagues from England determined the clinical outcome after the first corticosteroid-therapy.
The researches also identified factors which predict response/failure.
The research team included 216 patients in a 5-year inception cohort, of which 136 had ulcerative colitis and 80 had Crohn's disease.
The outcomes of early and late responses were used.
Multivariate analyses were performed to identify factors associated with outcome.
The researcher identified that 63% and 75% of ulcerative colitis and Crohn's disease required corticosteroid therapy, respectively.
| At 30 days in Crohn's disease, 40% of patients showed complete response|
|Alimentary Pharmacology & Therapeutics|
In ulcerative colitis, at 30 days, 51%, 31% and 18% patients demonstrated complete response, partial response and no response, respectively.
The researchers observed the same outcomes for Crohn's disease, in 40%, 35%, and 25%, respectively.
After 1 year, 55%, 17%, and 21% of patients with ulcerative colitis demonstrated prolonged response, corticosteroid-dependence or required surgery, respectively.
For Crohn's disease, the team observed these outcomes in 38%, 24%, and 35% of patients.
Extensive ulcerative colitis was a predictor of surgery.
The researchers noted that in Crohn's disease, IBD behavior was negatively associated with surgery.
Dr Ho's team commented, “Although corticosteroids are effective, dependence/resistance remains common.”
“Patients with extensive ulcerative colitis and fistulizing/stricturing Crohn's are most at risk of failing corticosteroid therapy.”