Admission Steroid Use, Serum Albumin And Endoscopic Severity Predict Intravenous Steroid Failure In Patients With Acute Severe Ulcerative Colitis

ow naded rom http:urnals.lw w om ajg by hD M fePH bH 4TIm qeA+lpW IIBonhQ l60EtgYrLzSPu+hU apK5dvm s8 on 069/2021 Downloadedfromhttp://journals.lww.com/ajgbyBhDMf5ePHKbH4TTImqenVA+lpWIIBvonhQl60EtgtdlLYrLzSPu+hUapVK5dvms8on06/29/2021 occurring in 53.2% of patients with DC and 59.1% in UC. Recurrent use of corticosteroids (27.7% in CD and 27.3% in UC) followed by treatment de-escalation (29.8% in DC and 22.7% in UC) were also causes of treatment modification. Currently, 21.4% of patients with CD use immunosuppressants as monotherapy and 44.6% use biologicals as monotherapy compared to UC, where 0% and 3% use immunosuppressants or biologicals as monotherapy (P5,0.001). In UC, 30.3% use 5-aminoscalicyclic acid (5-ASA) as monotherapy, 15.2% require combined therapy with 5-ASA and immunosuppressants and 9.1% require combined therapy with biological, immunosuppressants and 5-ASA. Corticosteroids are still being used in combination with 5-ASA in 24.2% of this sample. Median time until biological prescription was 14 months and 15.9 in CD and UC respectively (P 5 0.511). CONCLUSION: In this study, most patients required treatment modification, most cases due to lack of response. This finding highlights the severity of PIBD, where immunosuppression and combined therapy are often required. Monotherapy was statically more frequent in CD than UC. This probably reflects a misconception in terms of immunosuppression in UC. Use of corticosteroids was also more frequently seen in UC than CD.