Dr Jeffrey Hyams and colleagues from Connecticut determined the clinical outcome after corticosteroid therapy in children who are newly diagnosed with ulcerative colitis.
The investigators gathered data prospectively from the Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry database between 2002 and 2005.
All children who were newly diagnosed with inflammatory bowel disease younger than the age of 16 years were managed according to the dictates of their respective physicians.
The investigative team collected demographic, clinical, and laboratory data at diagnosis, at 30 days, and then quarterly.
|Corticosteroid dependence is seen in 45% of patients|
|Clinical Gastroenterology & Hepatology|
Patients were classified as corticosteroid responsive, corticosteroid dependent, or refractory.
The team determined outcomes at 3 months and at 1 year.
The team noted that 97 patients had a diagnosis of ulcerative colitis and a minimum of 1 year of follow-up evaluation.
Of these patients, 77 received corticosteroids.
At diagnosis, 81% of corticosteroid-treated patients had moderate/severe disease, and 81% had pancolitis.
For those treated early with corticosteroids, the investigators observed that disease activity at 3 months was inactive in 60%, mild in 27%, and moderate or severe in 11%.
At 1 year, 31 of 62 of the early corticosteroid-treated patients were considered corticosteroid responsive and 28 were corticosteroid dependent.
The team noted that 5% of patients receiving corticosteroids required colectomy in the first year.
Immunomodulators were used in 61% of all corticosteroid-treated patients.
Dr Hyam's team concludes, “Although short-term clinical response to corticosteroids in children with newly diagnosed ulcerative colitis is excellent, even with the common use of immunomodulators corticosteroid dependence is seen in 45% of patients.”