Document Detail


Outcomes of patients with microscopic colitis treated with corticosteroids: a population-based study.
MedLine Citation:
PMID:  23295275     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the outcomes of corticosteroid-treated microscopic colitis (MC) in a population-based cohort, and to compare these outcomes in patients treated with prednisone or budesonide.
METHODS: A historical cohort study of Olmsted County, Minnesota residents diagnosed with collagenous or lymphocytic colitis (LC) between 1986 and 2010 was performed using the Rochester Epidemiology Project.
RESULTS: Of 315 patients with MC, 80 (25.4%) were treated with corticosteroids. The median age at colitis diagnosis was 66.5 years (range: 16-95) and 78.7% were female. Forty patients (50%) had LC and 40 (50%) had collagenous colitis. Prednisone was used in 17 patients (21.2%) and budesonide in 63 (78.8%); 56 (75.6%) had complete response and 15 (20.3%) had partial response. Patients treated with budesonide had a higher rate of complete response than those treated with prednisone (82.5 vs. 52.9%; odds ratio, 4.18; 95% CI, 1.3-13.5). Six patients were lost to follow-up. The remaining 74 had a median follow-up of 4 years (range 0.2-14). Fifty patients out of the 71 who responded (70.4%) had a recurrence after corticosteroid discontinuation. Patients treated with budesonide were less likely to recur than those treated with prednisone (hazard ratio, 0.38; 95% CI, 0.18-0.85; P=0.02). After 397 person years of follow-up in the 73 patients with long-term data, 47 (64.4%) required maintenance with corticosteroids.
CONCLUSION: Patients with MC often respond to corticosteroid therapy, but with a high relapse rate. Budesonide had a higher response rate and a lower risk of recurrence than prednisone.
Authors:
Nicole M Gentile; Adil A Abdalla; Sahil Khanna; Thomas C Smyrk; William J Tremaine; William A Faubion; Patricia P Kammer; William J Sandborn; Edward V Loftus; Darrell S Pardi
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2013-01-08
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  108     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-05     Completed Date:  2013-03-22     Revised Date:  2013-08-09    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  256-9     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenal Cortex Hormones / therapeutic use*
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents / therapeutic use*
Budesonide / therapeutic use*
Chronic Disease
Cohort Studies
Colitis, Microscopic / drug therapy*,  epidemiology,  pathology,  prevention & control
Disease-Free Survival
Female
Follow-Up Studies
Gastrointestinal Agents / therapeutic use*
Humans
Male
Medical Records
Middle Aged
Minnesota / epidemiology
Odds Ratio
Prednisone / therapeutic use*
Proportional Hazards Models
Recurrence / prevention & control
Retrospective Studies
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 AG034676/AG/NIA NIH HHS; R01 AG034676/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anti-Inflammatory Agents; 0/Gastrointestinal Agents; 51333-22-3/Budesonide; 53-03-2/Prednisone
Comments/Corrections

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