How effective are the usual treatments for ulcerative colitis?

Bebb, James R.; Scott, Boyd B.

doi:10.1111/j.1365-2036.2004.02018.x

Cited by 57 publications

(55 citation statements)

References 38 publications

(57 reference statements)

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“…However, especially in Japan where the rate of UC is lower than in Western countries (about 1/10), prognostic studies of UC using such a method need an enormous sample size and would not be realistic. Third, the rate of complete response in the present study may be higher than in some earlier reports [13,27,28,29]. However, the definition of complete response in the present study is different from earlier studies in which the treatment effectiveness of only one medicine is reported.…”

Section: Discussioncontrasting

confidence: 55%

What Determines the Later Clinical Course of Patients Who Do Not Undergo Colectomy at the First Attack A Japanese Cohort Study on Ulcerative Colitis

et al. 2010

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Background/Aims: Several earlier studies on factors predicting the long-term outcome of ulcerative colitis only encompassed treatment failure for one severe episode, or suffered from a lack of multivariate analyses. We aimed to identify factors assessable at diagnosis or after the first induction therapy which predicted relapse or later colectomy in patients with mild to severe ulcerative colitis. Methods: Clinical parameters (age, sex, disease extent, and disease activity at diagnosis) and laboratory data (hemoglobin, albumin, C-reactive protein, and erythrocyte sedimentation rate at diagnosis and 4 weeks after the first induction therapy) were evaluated in 296 patients (median follow-up 87 months). Factors predicting relapse and later colectomy were sought using the Cox proportional hazard model. Results: The presence of moderate or severe disease at diagnosis were significant predictors of relapse [adjusted hazard ratio (95% CI) 2.07 (1.48–2.89) and 1.70 (1.06–2.72), respectively] and later colectomy [3.40 (1.09–10.54) and 6.77 (1.92–23.86)]. After the first induction therapy, hemoglobin and albumin were associated with relapse [0.87 (0.76–0.99) and 0.58 (0.41–0.83)] and later colectomy [0.60 (0.47–0.77) and 0.11 (0.06–0.22)]. Conclusion: Relapse and later colectomy were associated with (1) disease activity at diagnosis and (2) lower levels of hemoglobin and albumin after the first induction therapy.

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Section: Discussioncontrasting

confidence: 55%

What Determines the Later Clinical Course of Patients Who Do Not Undergo Colectomy at the First Attack A Japanese Cohort Study on Ulcerative Colitis

et al. 2010

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“…[4][5][6] Overall, induction of remission has been achieved/reported in approximately half of IBD patients, whereas roughly two-thirds of patients remained in remission at 6-12 months of thiopurine therapy. 5,7,8 Although thiopurines are considered to be effective and relatively safe drugs for maintenance therapy, up to 40%-50% of IBD patients discontinue thiopurine therapy during the course of disease. 9,10 The reason for discontinuation of thiopurine therapy is usually the occurrence of intolerable adverse events, which is reported in 10%-28% of the IBD patients using thiopurines.…”

mentioning

confidence: 99%

Thiopurine therapy in inflammatory bowel disease patients: Analyses of two 8-year intercept cohorts

Jharap

Seinen

Boer

et al. 2010

Inflammatory Bowel Diseases

181

159

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Azathioprine and 6-mercaptopurine were considered effective in approximately 40% of IBD patients after 5 years of treatment. A quarter of the patients discontinued thiopurines within 3 months, mostly due to adverse events. A high 6-MMP concentration or 6-MMP/6-TGN ratio was associated with therapeutic failure. If thiopurine use was successfully initiated in the first months, its use was usually extended over many years, as long-term use was associated with continuation of therapy.

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“…In previous studies, the role of rectal formulation of BDP in treatment of UC has been evaluated in comparison with 5-ASA or prednisolone sodium phosphate enemas showing similar efficacy for mild or moderate distal disease. [8][9][10][11][12][13][14][15][16][17][18] A standard dose of BDP 5 mg od (1 tablet day) has been established in the study conducted by Rizzello et al 9 In this study, administration of 5 mg or 10 mg daily showed therapeutic equivalence in patients affected by mild to moderate extensive or left-sided UC, whilst morning plasma cortisol level decreased in the 10 mg group without changes in vital signs. Oral BDP at a standard dose has been studied in treatment of active extensive or left-sided UC, either in combination with 5-ASA or alone resulting effective and safe, without signs of pituitaryadrenal function impairment.…”

Section: Discussionmentioning

confidence: 85%

“…[10][11][12][13] Patients who clinically failed to respond to treatment after 2 weeks were considered eligible for this single center prospective study. osteoporosis, history of drug or substance abuse, active gastroduodenal ulcer, moderate or severe hypertension, pregnancy and brestfeeding.…”

Section: Patientsmentioning

confidence: 99%

Oral high dose Beclomethasone dipropionate for treatment of active ulcerative colitis

Raimondo

Mangiavillano

et al. 2012

Gastroenterol Insights

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Oral corticosteroids (CS) have been widely used for treatment of ulcerative colitis (UC) at the price of systemic side effects. Role of topically active oral beclomethasone dipropionate (BDP) in clinical practice is still unclear. The aim of this paper is to investigate efficacy and tolerability of a high dose BDP regimen in mild to moderately active UC. Twenty-five patients (9 males, aged 25-40 years) with mild to moderately active UC, unresponsive to oral and topical 5-ASA (4.8 gr daily) and BDP (5 mg daily), were enrolled. All patients continued 5-ASA plus high dose oral BDP (15 mg od for 4 weeks and than tapered). Clinical, endoscopic, histological and laboratory parameters were monitored. Mean disease activity index (DAI) score at study entry was 8.82±4. Response to treatment was observed in all patients after 2 weeks. Remission was observed in all patients within 4-6 weeks from entering the study (mean DAI score: 2.34±0.5) and maintained throughout 6-month follow-up. No major adverse events were documented. Quality of life global evaluation score improved. This study provides the first evidence of efficacy and safety of high dose oral BDP-scheme in UC demonstrating excellent tolerability and favourable acceptability profile. This new BDPscheme might be a valid alternative to conventional oral CS when standard dose BDP is not effective. Future studies are needed to explore further clinical indications.

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How effective are the usual treatments for ulcerative colitis?

Cited by 57 publications

References 38 publications

What Determines the Later Clinical Course of Patients Who Do Not Undergo Colectomy at the First Attack A Japanese Cohort Study on Ulcerative Colitis

What Determines the Later Clinical Course of Patients Who Do Not Undergo Colectomy at the First Attack A Japanese Cohort Study on Ulcerative Colitis

Thiopurine therapy in inflammatory bowel disease patients: Analyses of two 8-year intercept cohorts

Oral high dose Beclomethasone dipropionate for treatment of active ulcerative colitis

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