The Natural History of Corticosteroid Therapy for Ulcerative Colitis in Children

Jeffrey Hyams, James Markowitz, Trudy Lerer, Anne Griffiths, David Mack, Athos Bousvaros, Anthony Otley, Jonathan Evans, Mariann Pfefferkorn, Joel Rosh, Robert Rothbaum, Subra Kugathasan, Adam Mezoff, Robert Wyllie, Vasundhara Tolia, J. Fernando delRosario, M. Susan Moyer, Maria Oliva-Hemker, Neal LeLeiko

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Abstract

Background & Aims: The aim of this study was to determine the clinical outcome after corticosteroid therapy in children who are newly diagnosed with ulcerative colitis (UC). Methods: Data were gathered prospectively from the Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry database between January 2002 and March 2005. All children who were newly diagnosed with inflammatory bowel disease younger than the age of 16 years were managed according to the dictates of their respective physicians. Demographic, clinical, and laboratory data were collected at diagnosis, at 30 days, and then quarterly. Patients were classified as corticosteroid responsive, corticosteroid dependent, or refractory, and outcomes were determined at 3 months and at 1 year. Results: Ninety-seven patients had a diagnosis of UC and a minimum of 1 year of follow-up evaluation; 77 (79%) received corticosteroids (62 within 30 days of diagnosis [early] and 15 between 31 days and 6 months [late]). At diagnosis, 81% of corticosteroid-treated patients (age, 11.3 ± 3.5 y) had moderate/severe disease, and 81% had pancolitis. For those treated early with corticosteroids, disease activity at 3 months was inactive in 60%, mild in 27%, and moderate/severe in 11%. At 1 year, 31 of 62 (50%) of the early corticosteroid-treated patients were considered corticosteroid responsive and 28 (45%) were corticosteroid dependent. A total of 4 patients receiving corticosteroids (5%) required colectomy in the first year. Immunomodulators were used in 61% of all corticosteroid-treated patients. Conclusions: Although short-term clinical response to corticosteroids in children with newly diagnosed UC is excellent, even with the common use of immunomodulators corticosteroid dependence is seen in 45% of patients.

Original languageEnglish (US)
Pages (from-to)1118-1123
Number of pages6
JournalClinical Gastroenterology and Hepatology
Volume4
Issue number9
DOIs
Publication statusPublished - Sep 2006
Externally publishedYes

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ASJC Scopus subject areas

  • Gastroenterology

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Hyams, J., Markowitz, J., Lerer, T., Griffiths, A., Mack, D., Bousvaros, A., ... LeLeiko, N. (2006). The Natural History of Corticosteroid Therapy for Ulcerative Colitis in Children. Clinical Gastroenterology and Hepatology, 4(9), 1118-1123. https://doi.org/10.1016/j.cgh.2006.04.008