Clinical outcomes and factors for response prediction after the first course of corticosteroid therapy in patients with active ulcerative colitis

Abstract

Our data showed that most Korean patients with active UC responded well to the first course of corticosteroid treatment. However, a considerable number of patients eventually turned out to be refractory to or dependent on this therapy. The initial higher Mayo score was strongly associated with poor outcomes.

Early endoscopic, laboratory and clinical predictors of poor disease course in paediatric ulcerative colitis

“…We have found that although variables reflecting disease severity at baseline have some predictive power for some of the outcomes, it is the short term response to initial induction treatment that is most predictive. This is in line with an adult Korean cohort showing that an initial good response to steroid treatment was associated with a favourable outcome 2. It seems that PUCAI, a non-invasive clinical index, can reliably guide treatment, as previously incorporated into the ECCO-ESPGHAN paediatric UC guidelines, both in the ambulatory and ASC setups 1 27.…”

“…In adults, several predictors have been suggested, including the Mayo score at diagnosis,2 histology,3 the need for steroids4 and faecal calprotectin 5. In a systematic review, the following variables predicted aggressive disease course in adult UC: age <40 years, pancolitis, presence of primary sclerosing cholangitis, lack of mucosal healing after induction treatment, high titre of perinuclear antineutrophil cytoplasmic antibodies and deep ulcerations in the colonic mucosa 6…”

Clinical Course of Intestinal Behcet’s Disease During the First Five Years

“…Furthermore, activity in the first 2 years after diagnosis was significantly correlated with an increased probability of five consecutive years of disease. In another study of UC patients who underwent corticosteroid treatment, a high initial Mayo score was strongly associated with poor outcomes [22]. Rutgeerts et al [23] found that a high disease activity score preoperatively predicted a postoperative course with high recurrence rates.…”

Monitoring of Therapy for Inflammatory Bowel Disease

“…The Pediatric UC Activity Index (PUCAI) proved to be highly predictive of steroid refractoriness in severe pediatric UC [12]. Additionally, Yoon et al [13 ]showed that a higher Mayo score was strongly associated with poor outcome indicating steroid dependency and proctocolectomy. In another study in 22 CD patients, the Harvey-Bradshaw Index significantly decreased after a single infusion of infliximab [14].…”