W. A. Faubion Jr., and colleagues, at the Mayo Clinic and Foundation, Rochester, Minnesota, USA, found that most patients with inflammatory bowel disease initially respond well to corticosteroids.
The research, conducted from 1970 to 1993, was carried out on patients in Olmsted County, Minnesota, diagnosed with Crohn's disease (n = 173) or ulcerative colitis (n = 185).
The immediate outcome (30 days) and 1-year outcome were determined after the first course of corticosteroids.
Immediate outcomes for Crohn's disease were complete remission in 58% of patients treated, partial remission in 26%, and no response in 16%.
For those patients with ulcerative colitis, 54% underwent complete remission, 30% partial remission, and 16% did not respond to treatment within 30 days.
32% off steroids; 28% steroid-dependent, 38% underwent operation
49% off steroids; 22% steroid-dependent, 29% underwent operation
After 1 year, 32% of Crohn's disease sufferers maintained a prolonged response to the initial corticosteroid treatment.
28% remained corticosteroid-dependent, 38% underwent operation, and 1% were lost to follow-up.
1-year outcomes for ulcerative colitis were prolonged response in 49%, corticosteroid dependence in 22%, and operation in 29%.
Writing in an accompanying editorial, Eugene B. Chang concluded that the overall clinical course of CD and UC in the community is relatively mild. "Less than half of patients ever require corticosteroid therapy."