Erschienen in:
21.11.2019 | Original Article
Corticosteroid Treatment at Diagnosis: An Analysis of Relapses, Disease Extension, and Colectomy Rate in Ulcerative Colitis
verfasst von:
Lorenzo Bertani, Giorgia Bodini, Maria Gloria Mumolo, Nicola de Bortoli, Linda Ceccarelli, Leonardo Frazzoni, Gherardo Tapete, Eleonora Albano, Maria Corina Plaz Torres, Massimo Bellini, Edoardo Savarino, Vincenzo Savarino, Santino Marchi, Francesco Costa
Erschienen in:
Digestive Diseases and Sciences
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Ausgabe 8/2020
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Abstract
Background
Ulcerative colitis is a chronic relapsing disease usually treated with mesalamine. The need of steroid therapy at diagnosis is generally considered as a poor prognostic factor.
Aims
The aim of our study was to assess whether patients treated with corticosteroids at diagnosis have more clinical relapses, disease progression, or an increased risk of colectomy during a 5-year follow-up.
Methods
We retrospectively evaluated patients who had received diagnosis of ulcerative colitis with a 5-year follow-up. Relapse was defined as a worsening of symptoms requiring an increase in medical treatment. Progression of disease was defined as a proximal extension of mucosal involvement, comparing the colonoscopy performed 5 years after diagnosis with the first one. The need of corticosteroid treatment at diagnosis was correlated to number of relapses, disease progression, and colectomy rate.
Results
We included 230 patients, 116 of them (50%) treated with steroids at diagnosis. Multivariate analysis demonstrated that there is a strong correlation between corticosteroid use and number of relapses (p < 0.01), as well as with disease progression (p < 0.05). Seventeen patients (7.4%) underwent colectomy, but the correlation with steroids was not statistically significant.
Conclusions
These data provide evidence that the need of corticosteroids at diagnosis is associated with a worse clinical outcome.