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- Title
Early corticosteroids requirement after the diagnosis of ulcerative colitis diagnosis can predict a more severe long-term course of the disease - a nationwide study of 1035 patients.
- Authors
Khan, N. H.; Almukhtar, R. M.; Cole, E. B.; Abbas, A. M.
- Abstract
Background There are limited data regarding clinical outcomes in ulcerative colitis ( UC) patients who require early corticosteroids ( CS) use. Aim To evaluate the rate of early CS utilisation (within 30 days of diagnosis) as a predictive marker for long-term outcomes, colectomy and CS dependency, in a population-based cohort of incident UC cases. Methods Nationwide data were obtained from the Veterans Affairs ( VA) health care system for the period 2001-2011. Incident UC cases were identified. A retrospective cohort design and time-to-event survival analysis were used to track outcomes of interest. Cox regression multivariate analysis was employed. Results One thousand and thirty-five newly diagnosed patients with UC were identified and included in the analysis; 236 (23%) of those patients required early CS therapy. Patients were followed-up over a median time of 4.7 years ( IQR 2.8-6.8) after UC diagnosis. The 5-year cumulative probability of requiring colectomy varied significantly by early CS use status (13% among early CS users compared to 4% among those who did not require early CS treatment, P < 0.001). Similar variation in the 5-year cumulative probability of CS dependency by early CS status was observed. Early CS users were more likely to require colectomy 2.9 ( CI 1.7-5.0, P < 0.001) and to become CS dependent 4.5 (95% CI 3.6-5.7, P < 0.001) than non-users. Conclusions Early CS use can help identify those patients who have a more active disease course of UC. Recognising this can be among the indicators that can help physicians identify patients who may require early initiation of more aggressive therapy.
- Subjects
ULCERATIVE colitis; CORTICOSTEROIDS; BIOMARKERS; MULTIVARIATE analysis; COLECTOMY
- Publication
Alimentary Pharmacology & Therapeutics, 2014, Vol 40, Issue 4, p374
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/apt.12834