e-med-isral-ribbon

גסטרואנטרולוגיה

Need for treatment with corticosteroids suggests poor prognosis in IBD patients

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – Most patients with inflammatory bowel disease don't require treatment with corticosteroids, according to a report in the August issue of Gastroenterology. Those who do require steroid therapy have a poor prognosis, particularly those with Crohn's disease.

To examine outcomes after a first course of corticosteroids, Dr. William J. Sandborn and colleagues from the Mayo Clinic and Foundation, Rochester, Minnesota, identified all patients diagnosed with Crohn's disease or ulcerative colitis between 1970 and 1993 who were treated with systemic corticosteroids. The team assessed 30-day and 1-year outcomes.

Of 171 patients with Crohn's disease, 43% received corticosteroid therapy. Of 183 patients with ulcerative colitis, 34% were treated with steroids. "Only a minority of patients are ever ill enough to require steroid therapy…thus, these diseases are in general more mild than would be apparent when looking at patients in referral centers," Dr. Sandborn pointed out in comments to Reuters Health.

"Steroids are highly effective with 84% of patients with both diseases responding initially," he continued. Among Crohn's disease patients, 58% of those who received corticosteroid therapy were in complete remission at 30 days, 26% were in partial remission and 16% had no response. For the patients with ulcerative colitis, the corresponding figures were 54%, 30% and 16%.

But at 1 year, 32% of Crohn's disease patients had a sustained response to steroids, 28% were corticosteroid-dependent and 38% had undergone surgical resection. In the ulcerative colitis group the rates were 49%, 22% and 29%, respectively.

"Patients who are ill enough to require steroid therapy have a poor prognosis, particularly patients with Crohn's disease," Dr. Sandborn said. Intestinal resection was necessary for 11 of 12 patients with Crohn's disease who were nonresponders, and colectomy was necessary for nine of 10 patients with ulcerative colitis who were nonresponders.

0 תגובות

השאירו תגובה

רוצה להצטרף לדיון?
תרגישו חופשי לתרום!

כתיבת תגובה

מידע נוסף לעיונך

כתבות בנושאים דומים

© ‫ אי-מד שיווק רפואי בע”מ
 כל הזכויות שמורות
09-765-8233 

 

הנך גולש/ת באתר כאורח/ת.

במידה והנך מנוי את/ה מוזמן/ת לבצע כניסה מזוהה וליהנות מגישה לכל התכנים המיועדים למנויים
עדיין לא מנוי/ה ונמנה/ת על הצוות הרפואי? מוזמן/ת לבצע הרשמה כאן
להרשמה לאתר
להמשך גלישה כאורח סגור חלון זה