التفاصيل البيبلوغرافية
العنوان: |
Prevalence of Corticosteroids Use and Disease Course After Initial Steroid Exposure in Ulcerative Colitis. |
المؤلفون: |
Khan, Nabeel nabeel.khan@va.gov, Abbas, Ali Ali.Abbas@medicine.ufl.edu, Williamson, Alice1 alicewilliamson@live.com, Balart, Luis lbalart@tulane.edu |
المصدر: |
Digestive Diseases & Sciences. Oct2013, Vol. 58 Issue 10, p2963-2969. 7p. |
مصطلحات موضوعية: |
*CORTICOSTEROIDS, *STEROIDS, *ULCERATIVE colitis, *DATA analysis, *HEALTH outcome assessment, *COLECTOMY |
مستخلص: |
Background: Limited nationwide data currently exists regarding corticosteroid (CS) use and long-term outcome after CS initiation in ulcerative colitis (UC). Aims: The purpose of this study was to assess CS use prevalence and long-term outcomes after the index CS exposure. Our outcomes of interest were CS use level (reintroduction, dependency, and refractoriness), thiopurine use, and colectomy. Methods: Nationwide data was obtained from the Veterans Affairs (VA) healthcare system for the period 2001-2011. Patients with UC were included if they had been diagnosed in the VA system and if they had filled CS for the first time during the observation period. A retrospective cohort design and time-to-event survival analysis was used to track outcomes of interest. Results: A total of 1,038 newly-diagnosed patients with UC were identified. The prevalence of CS use over the observation period was 45 %. Four hundred sixty-four CS users with median follow-up of 3.4 years were included. Among the included patients, 65 % required CS reintroduction, 38 % were classified as CS dependent, and 11 % were classified as CS refractory mostly within 2 years after the index CS course. Respectively, 8.6 and 38 % had colectomy and received thiopurine. Colectomy and thiopurine use rates varied significantly according to CS use level. Conclusions: Approximately half of newly-diagnosed patients with UC required CS. Among CS users, one third of the patients had a sustained response after the initial CS course while two-thirds required further CS therapy. We observed a trend towards higher than previously reported thiopurine use accompanied by marked reduction in colectomy rates. [ABSTRACT FROM AUTHOR] |
قاعدة البيانات: |
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