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Corticosteroid dependence is high in children with Crohn's

Most pediatric patients with Crohn's either are steroid dependent or require surgery after 1 year, finds the most recent issue of Inflammatory Bowel Diseases.

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Dr Jeanne Tung and colleagues examined the 1-year outcome after the first course of systemic corticosteroids in pediatric patients with inflammatory bowel disease (IBD).

The researchers identified 50 Minnesota residents diagnosed with Crohn's disease or 36 ulcerative colitis before 19 years of age from 1940 to 2001.

Outcomes at 30 days and 1 year after the initial course of corticosteroids were recorded.

After 1 year, 58% with Crohn's disease were steroid dependent
Inflammatory Bowel Diseases

The research team noted that 65% of patients with Crohn's disease and 44% with ulcerative colitis were treated with corticosteroids before age 19.

The team noted that 30-day outcomes for corticosteroid-treated Crohn's disease were complete remission in 62%.

The research team found partial remission in 27%, and no response in 12%, with 2 of these patients requiring surgery.

The researchers observed that 30-day outcomes for treated ulcerative colitis were complete remission in 50%, partial remission in 29%, and no response in 21%.

The 1-year outcomes for Crohn's disease were prolonged response in 42%, and corticosteroid dependence in 31%, whereas 27% were postsurgical.

The team noted that 1-year outcomes for ulcerative colitis were prolonged response in 57%, and corticosteroid dependence in 14%.

About 29% were postsurgical.

However, after 1 year, 58% with Crohn's disease and 43% with ulcerative colitis either were steroid dependent or required surgery.

Dr Tung's team concludes, “Most pediatric patients with inflammatory bowel disease initially responded to corticosteroids.”

“However, after 1 year, most pediatric patients with Crohn's disease and just under half of pediatric patients with ulcerative colitis either were steroid dependent or required surgery.”

“This finding emphasizes the need for early steroid-sparing medications in pediatric inflammatory bowel disease.”

Inflamm Bowel Dis 2006: 12(12): 1093-1100
24 November 2006

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