Analysis of the initial dose and reduction rate of corticosteroid for ulcerative colitis in clinical practice
Abstract Background and Aim Trends in steroid use and the effects of the initial dose, duration of use, and tapering schedule on clinical efficacy were assessed in Japanese patients with ulcerative colitis (UC) undergoing steroid treatment. Methods We enrolled 191 cases with UC who underwent steroid...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-09-01
|
| Series: | JGH Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgh3.12796 |
| _version_ | 1811260185345261568 |
|---|---|
| author | Masataka Masuda Norimasa Fukata Yasuki Sano Shuhei Nishimon Mamiko Aoi Takashi Tomiyama Toshiro Fukui Mika Omiya Kazuichi Okazaki Makoto Naganuma |
| author_facet | Masataka Masuda Norimasa Fukata Yasuki Sano Shuhei Nishimon Mamiko Aoi Takashi Tomiyama Toshiro Fukui Mika Omiya Kazuichi Okazaki Makoto Naganuma |
| author_sort | Masataka Masuda |
| collection | DOAJ |
| description | Abstract Background and Aim Trends in steroid use and the effects of the initial dose, duration of use, and tapering schedule on clinical efficacy were assessed in Japanese patients with ulcerative colitis (UC) undergoing steroid treatment. Methods We enrolled 191 cases with UC who underwent steroid treatment between 2006 and 2020. We assessed the difference in clinical remission rates in cases with different initial doses of steroid. Clinical factors for clinical remission at week 4 and discontinuation of corticosteroid within 12 weeks were also assessed. Results Clinical remission and response at week 4 were obtained in 107 (56.0%) and 58 cases (30.4%), respectively. In hospitalized patients, male sex (odds ratio [OR], 0.373; 95% confidence interval [CI], 0.146–0.956) and younger age (OR, 0.974; 95% CI, 0.951–0.998) were associated with clinical remission at week 4. Partial Mayo score (OR, 0.643; 95% CI, 0.451–0.918) and initial steroid dose of ≥30 mg (OR, 3.278; 95% CI, 1.274–8.435) were associated with clinical remission at week 4 in outpatients. Clinical remission at week 4 (OR, 0.300; (95% CI, 0.126–0.718)) and the steroid dose reduction rate at week 4 (OR, 0.092; 95% CI, 0.036–0.234) were associated with treatment discontinuation within 12 weeks. The proportion of patients in whom corticosteroids were discontinued at week 12 was significantly higher (P = 0.006) in 2016–2020 (28/52; 53.8%) than in 2006–2010 (15/54; 27.8%). Conclusion The steroid reduction rate at week 4 may be critical for discontinuation within 12 weeks. Withdrawal of corticosteroids has been becoming more appropriate in the last 5 years than before. |
| first_indexed | 2024-04-12T18:42:38Z |
| format | Article |
| id | doaj.art-a0afc42d5414434d919bc99b7e9ad55b |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-04-12T18:42:38Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-a0afc42d5414434d919bc99b7e9ad55b2022-12-22T03:20:43ZengWileyJGH Open2397-90702022-09-016961262010.1002/jgh3.12796Analysis of the initial dose and reduction rate of corticosteroid for ulcerative colitis in clinical practiceMasataka Masuda0Norimasa Fukata1Yasuki Sano2Shuhei Nishimon3Mamiko Aoi4Takashi Tomiyama5Toshiro Fukui6Mika Omiya7Kazuichi Okazaki8Makoto Naganuma9Third Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanThird Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanThird Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanThird Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanThird Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanThird Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanThird Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanThird Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanThird Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanThird Department of Internal Medicine, Division of Gastroenterology and Hepatology Kansai Medical University Hirakata Osaka JapanAbstract Background and Aim Trends in steroid use and the effects of the initial dose, duration of use, and tapering schedule on clinical efficacy were assessed in Japanese patients with ulcerative colitis (UC) undergoing steroid treatment. Methods We enrolled 191 cases with UC who underwent steroid treatment between 2006 and 2020. We assessed the difference in clinical remission rates in cases with different initial doses of steroid. Clinical factors for clinical remission at week 4 and discontinuation of corticosteroid within 12 weeks were also assessed. Results Clinical remission and response at week 4 were obtained in 107 (56.0%) and 58 cases (30.4%), respectively. In hospitalized patients, male sex (odds ratio [OR], 0.373; 95% confidence interval [CI], 0.146–0.956) and younger age (OR, 0.974; 95% CI, 0.951–0.998) were associated with clinical remission at week 4. Partial Mayo score (OR, 0.643; 95% CI, 0.451–0.918) and initial steroid dose of ≥30 mg (OR, 3.278; 95% CI, 1.274–8.435) were associated with clinical remission at week 4 in outpatients. Clinical remission at week 4 (OR, 0.300; (95% CI, 0.126–0.718)) and the steroid dose reduction rate at week 4 (OR, 0.092; 95% CI, 0.036–0.234) were associated with treatment discontinuation within 12 weeks. The proportion of patients in whom corticosteroids were discontinued at week 12 was significantly higher (P = 0.006) in 2016–2020 (28/52; 53.8%) than in 2006–2010 (15/54; 27.8%). Conclusion The steroid reduction rate at week 4 may be critical for discontinuation within 12 weeks. Withdrawal of corticosteroids has been becoming more appropriate in the last 5 years than before.https://doi.org/10.1002/jgh3.12796corticosteroidinitial dose of corticosteroidreduction rate of corticosteroidulcerative colitis |
| spellingShingle | Masataka Masuda Norimasa Fukata Yasuki Sano Shuhei Nishimon Mamiko Aoi Takashi Tomiyama Toshiro Fukui Mika Omiya Kazuichi Okazaki Makoto Naganuma Analysis of the initial dose and reduction rate of corticosteroid for ulcerative colitis in clinical practice JGH Open corticosteroid initial dose of corticosteroid reduction rate of corticosteroid ulcerative colitis |
| title | Analysis of the initial dose and reduction rate of corticosteroid for ulcerative colitis in clinical practice |
| title_full | Analysis of the initial dose and reduction rate of corticosteroid for ulcerative colitis in clinical practice |
| title_fullStr | Analysis of the initial dose and reduction rate of corticosteroid for ulcerative colitis in clinical practice |
| title_full_unstemmed | Analysis of the initial dose and reduction rate of corticosteroid for ulcerative colitis in clinical practice |
| title_short | Analysis of the initial dose and reduction rate of corticosteroid for ulcerative colitis in clinical practice |
| title_sort | analysis of the initial dose and reduction rate of corticosteroid for ulcerative colitis in clinical practice |
| topic | corticosteroid initial dose of corticosteroid reduction rate of corticosteroid ulcerative colitis |
| url | https://doi.org/10.1002/jgh3.12796 |
| work_keys_str_mv | AT masatakamasuda analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice AT norimasafukata analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice AT yasukisano analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice AT shuheinishimon analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice AT mamikoaoi analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice AT takashitomiyama analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice AT toshirofukui analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice AT mikaomiya analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice AT kazuichiokazaki analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice AT makotonaganuma analysisoftheinitialdoseandreductionrateofcorticosteroidforulcerativecolitisinclinicalpractice |