Performing colonoscopy before steroid induction is associated with shorter steroid use in patients with ulcerative colitis.
Intest Res
; 21(2): 205-215, 2023 Apr.
Article
en En
| MEDLINE
| ID: mdl-36516820
ABSTRACT
BACKGROUND/AIMS:
Risks of long-term steroid use in patients with ulcerative colitis (UC) outweigh the benefits, thus dosing should be tapered once a response is achieved. Colonoscopy is a key technique for assessing disease severity and optimizing treatment involving steroids. This retrospective longitudinal cohort study of patients with UC explored factors associated with the duration of systemic steroid use.METHODS:
The Japan Medical Data Center database, an employer-based insurance claims database, was used to select individuals initiating prednisolone, with a prescription issued between January 1, 2010, and January 31, 2018. The study included adults with a confirmed diagnosis of UC, who had received ≥1 year of continuous treatment with 5-aminosalicylic acid, biologics, or thiopurine. Factors associated with prednisolone duration were assessed using a multivariate regression model.RESULTS:
Median duration of prednisolone treatment was 98 days, and colonoscopy was performed ≤1 month before or at the first prescription of prednisolone (index date) in 32.8% of patients (607/1,853). Shorter durations of prednisolone treatment were associated with colonoscopy ≤1 month before or at the index date and higher prednisolone dose at index date, with incidence rate ratios (IRRs) of 0.776 (95% confidence interval [CI], 0.682-0.884; P<0.001) and 0.998 (95% CI, 0.996-1.000; P=0.018), respectively. Charlson Comorbidity Index scores of 1 and ≥2 predicted longer prednisolone treatment (IRR, 1.332; 95% CI, 1.174-1.511; P<0.001 and IRR, 1.599; 95% CI, 1.357-1.885; P<0.001, respectively).CONCLUSIONS:
Performing colonoscopy before or at the time of initiating steroid was associated with a shorter duration of steroid use in patients with UC.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Intest Res
Año:
2023
Tipo del documento:
Article
País de afiliación:
Japón