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Alimentary pharmacology & therapeutics · 2024

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

СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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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, IBD Terakoya Group

Аннотация

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.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты