TY - JOUR
T1 - Factors Associated with Response to Systemic Corticosteroids in Active Ulcerative Colitis
T2 - Results from a Prospective, Multicenter Trial
AU - Austrian IBD Study Group (ATISG)
AU - Blesl, Andreas
AU - Borenich, Andrea
AU - Gröchenig, Hans Peter
AU - Novacek, Gottfried
AU - Primas, Christian
AU - Reinisch, Walter
AU - Kutschera, Maximilian
AU - Illiasch, Constanze
AU - Hennlich, Barbara
AU - Steiner, Pius
AU - Koch, Robert
AU - Tillinger, Wolfgang
AU - Haas, Thomas
AU - Reicht, Gerhard
AU - Mayer, Andreas
AU - Ludwiczek, Othmar
AU - Miehsler, Wolfgang
AU - Steidl, Karin
AU - Binder, Lukas
AU - Baumann-Durchschein, Franziska
AU - Fürst, Stefan
AU - Reider, Simon
AU - Watschinger, Christina
AU - Wenzl, Heimo
AU - Moschen, Alexander
AU - Berghold, Andrea
AU - Högenauer, Christoph
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/7/24
Y1 - 2023/7/24
N2 - BACKGROUND: Among patients with ulcerative colitis, 30-50% receive corticosteroids within the first five years after diagnosis. We aimed to reconsider their effectiveness in the context of the biologic era.METHODS: In this prospective, multicenter study, patients with active ulcerative colitis (Lichtiger score ≥ 4) were eligible if initiating systemic corticosteroids. The primary endpoint was clinical response (decrease in the Lichtiger score of ≥50%) at week 4. Secondary endpoints included combined response defined as clinical response and any reduction in elevated biomarkers (CRP and/or calprotectin). Steroid dependence was assessed after three months.RESULTS: A total of 103 patients were included. Clinical response was achieved by 73% of patients, and combined response by 68%. A total of 15% of patients were steroid-dependent. Activity of colitis did not influence short-term response to treatment but increased the risk for steroid dependence. Biologic-naïve patients responded better than biologic-experienced patients. Past smoking history (OR 5.38 [1.71, 20.1], p = 0.003), hemoglobin levels (OR 0.76 [0.57, 0.99] for higher levels, p = 0.045), and biologic experience (OR 3.30 [1.08, 10.6], p = 0.036) were independently associated with nonresponse.CONCLUSION: Disease activity was not associated with short-term response to systemic corticosteroids but was associated with steroid dependence in patients with active ulcerative colitis. Exposure to biologics negatively affects response rates.
AB - BACKGROUND: Among patients with ulcerative colitis, 30-50% receive corticosteroids within the first five years after diagnosis. We aimed to reconsider their effectiveness in the context of the biologic era.METHODS: In this prospective, multicenter study, patients with active ulcerative colitis (Lichtiger score ≥ 4) were eligible if initiating systemic corticosteroids. The primary endpoint was clinical response (decrease in the Lichtiger score of ≥50%) at week 4. Secondary endpoints included combined response defined as clinical response and any reduction in elevated biomarkers (CRP and/or calprotectin). Steroid dependence was assessed after three months.RESULTS: A total of 103 patients were included. Clinical response was achieved by 73% of patients, and combined response by 68%. A total of 15% of patients were steroid-dependent. Activity of colitis did not influence short-term response to treatment but increased the risk for steroid dependence. Biologic-naïve patients responded better than biologic-experienced patients. Past smoking history (OR 5.38 [1.71, 20.1], p = 0.003), hemoglobin levels (OR 0.76 [0.57, 0.99] for higher levels, p = 0.045), and biologic experience (OR 3.30 [1.08, 10.6], p = 0.036) were independently associated with nonresponse.CONCLUSION: Disease activity was not associated with short-term response to systemic corticosteroids but was associated with steroid dependence in patients with active ulcerative colitis. Exposure to biologics negatively affects response rates.
UR - http://www.scopus.com/inward/record.url?scp=85166320399&partnerID=8YFLogxK
U2 - 10.3390/jcm12144853
DO - 10.3390/jcm12144853
M3 - Journal article
C2 - 37510968
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 14
M1 - 4853
ER -