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KMID : 0338420220370061140
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The Korean Journal of Internal Medicine
2022 Volume.37 No. 6 p.1140 ~ p.1152
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Oral beclomethasone dipropionate as an add-on therapy and response prediction in Korean patients with ulcerative colitis
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Kim Kyu-Won
Hong Hee-Seung
Oh Kyung-hwan
Lee Jae-Yong
Hong Seung-Wook
Park Jin-Hwa
Hwang Sung-Wook
Yang Dong-Hoon
Byeon Jeong-Sik
Myung Seung-Jae
Yang Suk-Kyun
Ye Byong-Duk
Park Sang-Hyoung
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Abstract
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Background/Aims : We aimed to investigate the oral beclomethasone dipropionate’s (BDP) efficacy as an add-on therapy and to clarify the predictive factor for response to oral BDP in Korean ulcerative colitis (UC) patients.
Methods : Patients with a stable concomitant drug regimen with exposure to oral BDP (5 mg/day) within 30 days before BDP initiation were included. Partial Mayo score (pMS) was used to evaluate response to oral BDP. Clinical remission (CREM) was defined as a post-treatment pMS ≤ 1 point. Clinical response (CRES) was defined as an at least 2-point decrease in post-treatment pMS and an at least 30% decrease from baseline pMS. Patients without CREM or CRES were considered nonresponders (NRs).
Results : Of all, 37 showed CREM, 19 showed CRES, and 44 were NRs. The CREM group included more patients with mild disease activity (75.7% vs. 43.2%, p = 0.011) than NRs. In contrast to NRs, CREM and CRES patients showed significant improvement of post-treatment erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (ESR with p = 0.001, CRP with p = 0.004, respectively). Moreover, the initial rectal bleeding subscore (RBS) was significantly different between CREM and CRES, or NR (both with p < 0.001). In multivariate analyses, initial stool frequency subscore (SFS) of 0 and RBS of 0 were predictive factors for CREM (odds ratio [OR], 15.359; 95% confidence interval [CI], 1.085 to 217.499; p = 0.043 for SFS, and OR, 11.434; 95% CI, 1.682 to 77.710; p = 0.013 for RBS).
Conclusions : Oral BDP is an efficacious add-on therapy in Korean UC patients. Patients with initial SFS or RBS of 0 may be particularly good candidates for oral BDP.
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KEYWORD
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Beclomethasone, Colitis, ulcerative, Treatment outcome
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