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- Title
Long-Term Colectomy Rate After Intensive Intravenous Corticosteroid Therapy for Ulcerative Colitis Prior to the Immunosuppressive Treatment Era.
- Authors
Gustavsson, Anders; Halfvarson, Jonas; Magnuson, Anders; Sandberg-Gertzén, Hanna; Tysk, Curt; Järnerot, Gunnar
- Abstract
OBJECTIVES: Corticosteroids are a cornerstone in the treatment of a severe attack of ulcerative colitis (UC). The long-term prognosis in this patient group is not well described. We studied the long-term colectomy and relapse rates in patients given intensive intravenous corticosteroid treatment (IIVT) for acute UC. METHODS: A retrospective clinical study of 158 patients with UC treated in 1975–1982 with IIVT. Patients were followed-up to death, colectomy or last visit. RESULTS: A total of 11 patients were excluded due to change of diagnosis (N = 10) or lost to follow-up (N = 1). The indication for index IIVT in the remaining 147 patients was a severe attack (N = 61), a moderately severe attack (N = 45), a mild attack (N = 29) or chronic continuous disease (N = 12). The median (range) duration of follow-up was 173 (4–271) months in patients escaping colectomy during the first 3 months. Three months after IIVT, the colectomy rates were 28/61 (46%) in a severe attack, 4/45 (9%) in a moderately severe, and 1/29 (3%) in a mild attack. After 10 yr, the colectomy rates were 39/61 (64%), 22/45 (49%), and 8/29 (28%), respectively. During follow-up, neither colectomy incidence beyond 3 months, time to first relapse nor relapse incidence was influenced by severity of initial attack, except for a lower relapse incidence after a severe attack. CONCLUSIONS: In patients escaping colectomy during the first 3 months after IIVT, the future prognosis was similar irrespective of initial disease severity.
- Subjects
CLINICAL trials; CORTICOSTEROIDS; HORMONE therapy; INFLAMMATORY bowel disease treatment; ULCERATIVE colitis; COLECTOMY; COLON surgery; IMMUNOSUPPRESSIVE agents; PROGNOSIS
- Publication
American Journal of Gastroenterology (Springer Nature), 2007, Vol 102, Issue 11, p2513
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.2007.01435.x