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Recent steroid use and the relapse risk in ulcerative colitis patients with endoscopic healing.

Authors :
Fukuda, Tomohiro
Yamazaki, Hajime
Miyatani, Yusuke
Sawada, Tsunaki
Shibuya, Naoki
Fukuo, Yuka
Kiyohara, Hiroki
Morikubo, Hiromu
Tominaga, Keiichi
Kakimoto, Kazuki
Imai, Takayuki
Yaguchi, Katsuki
Yamamoto, Shojiro
Ando, Katsuyoshi
Nishimata, Nobuaki
Yoshihara, Takeo
Andoh, Akira
Hibi, Toshifumi
Matsuoka, Katsuyoshi
Sugiyama, Tomoya
Source :
Alimentary Pharmacology & Therapeutics; Jul2024, Vol. 60 Issue 1, p43-51, 9p
Publication Year :
2024

Abstract

Summary: Background: Endoscopic healing (EH) is a therapeutic target in ulcerative colitis (UC). However, even patients who have achieved EH relapse frequently. Aims: To investigate the association between recent steroid use and relapse risk in UC patients with EH. Methods: This multi‐centre cohort study included 1212 UC patients with confirmed EH (Mayo endoscopic subscore ≤1). We excluded patients with current systemic steroid use or history of advanced therapy. We divided patients into a recent steroid group (last systemic steroid use within 1 year; n = 59) and a non‐recent or steroid‐naïve group (n = 1153). We followed the patients for 2 years to evaluate relapse, defined as induction of systemic steroids or advanced therapy. We used logistic regression to estimate the odds ratio (OR) of relapse. Results: Relapse occurred in 28.8% of the recent steroid group and 5.6% of the non‐recent/steroid‐naïve group (multi‐variable‐adjusted OR 5.53 [95% CI 2.85–10.7]). The risk of relapse decreased with time since the last steroid use: 28.8% for less than 1 year after steroid therapy, 22.9% for 1 year, 16.0% for 2 years and 7.9% beyond 3 years, approaching 4.0% in steroid‐naïve patients. (ptrend <0.001). Conclusions: Even for patients with UC who achieved EH, the risk of relapse remains high following recent steroid therapy. Physicians need to consider the duration since last steroid use to stratify the relapse risk in UC patients with EH. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
02692813
Volume :
60
Issue :
1
Database :
Complementary Index
Journal :
Alimentary Pharmacology & Therapeutics
Publication Type :
Academic Journal
Accession number :
177798167
Full Text :
https://doi.org/10.1111/apt.18013