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KMID : 1188320130070010058
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Gut and Liver
2013 Volume.7 No. 1 p.58 ~ p.65
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Clinical Outcomes and Predictive Factors for Response after the First Course of Corticosteroid Therapy in Patients with Crohn’s Disease
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Kim Duk-Hwan
Cheon Jae-Hee
Park Jae-Jun
Yoon Jin-Young
Moon Chang-Mo
Hong Sung-Pil
Kim Tae-Il
Kim Won-Ho
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Abstract
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Background/Aims:This study sought to determine the natural course of Crohn’s disease (CD) and identify predictors that could indicate responsiveness to corticosteroid (CS) therapy.
Methods:Patients with active CD who were treated with oral CS at a single institution between August 1994 and February 2008 were retrospectively reviewed. The clinical outcomes at 1 month, 4 months, and 1 year after the treatment, as well as clinical and biochemical parameters at the time of CS initiation, were evaluated.
Results:A total of 96 patients with CD were enrolled. In this study, 37 patients achieved complete remission (38.5%), 49 achieved partial remission (51.0%), and 10 (10.4%) showed no response at 1 month after the initiation of CS treatment. At 4 months and 1 year after treatment, 66 (69.5%) and 47 (56.6%) patients showed prolonged response, 22 (23.2%) and 20 (24.1%) showed steroid dependency, and 7 (7.4%) and 16 (19.3%) showed refractoriness, respectively. Nonstricturing and nonpenetrating behaviors and a lower CD activity index demonstrated clinical significance for mid-term or mid- and long-term steroid responses, respectively.
Conclusions:The short-term response rate to initial oral CS therapy in CD was considerably high, but responsiveness thereafter showed a tendency to decrease with time. Clinical parameters reflecting mild inflammation were associated with responsiveness after CS treatment.
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KEYWORD
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Inflammatory bowel diseases, Crohn disease, Adrenal cortex hormones, Steroids
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