P176 Clinical features of acute severe ulcerative colitis according to steroid dependency: A KASID multicenter study
Kim, D.H.(1)*;Kim, H.S.(2);Kim, E.S.(3);Park, S.H.(4);Kim, S.J.(5);Kim, K.O.(6);Lee, Y.J.(7);Song, E.M.(8);Kim, D.S.(9);
(1)Chonnam National University Hospital, Division of gastroenterology- Department of Internal medicine and Inflammatory Bowel disease Clinic, Gwnagju, Korea- Republic Of;(2)Chonnam National University Hospital, Department of Internal Medicine- Division of Gastroenterology and Clnics of Inflammatory Bowel Disease, Gwangju, Korea- Republic Of;(3)Kyungpook University Hospital, Department of Internal Medicine- Division of Gastroenterology, Daegu, Korea- Republic Of;(4)Asan Medical Center, Department of Internal Medicine- Division of Gastroenterology, Seoul, Korea- Republic Of;(5)Chosun University Hospital, Department of Internal Medicine- Division of Gastroenterology, Gwangju, Korea- Republic Of;(6)Yeungnam University Hospital, Department of Internal Medicine- Division of Gastroenterology, Gwangju, Korea- Republic Of;(7)Keimyung University Hospital, Department of Internal Medicine- Division of Gastroenterology, Daegu, Korea- Republic Of;(8)Ewha Womans University Seoul Hospital, Department of Internal Medicine- Division of Gastroenterology, Seoul, Korea- Republic Of;(9)Konyang University Hospital, Department of Internal Medicine- Division of Gastroenterology, Daejeon, Korea- Republic Of; IBD Research Group in Korean Association for the Study of the Intestinal Diseases (KASID)
Background
Intravenous steroid therapy is the main initial treatment for acute severe ulcerative colitis (ASUC). However, steroid dependence in patients who were treated with intravenous steroid therapy for ASUC is not fully evaluated. We aimed to determine the prevalence and risk factors of corticosteroid dependence after treatment of ASUC.
Methods
Adult patients who were admitted for the treatment of ASUC satisfying Truelove-Witts criteria from January 2015 to December 2020 were included in the study. Steroid dependence was defined as a failure to taper steroids below 10 mg within 3 months from initiating intravenous therapy or relapse within 3 months after steroid discontinuation.
Results
Among a total of 140 patients who received intravenous steroids as initial treatment for ASUC, 105 (75.0%) showed a response while 35 (25.0%) were refractory to steroids. Of 105 patients who responded to intravenous steroid therapy, 21 (20.0%) showed steroid dependence during the follow-period. Demographic and clinical variables were not significantly different between steroid-dependent and steroid response groups. However, initial C-reactive protein (CRP) levels in steroid-dependent groups were numerically lower compared with those in the steroid response group with statistical significance (4.4 ± 4.6 mg/dL versus 7.0 ± 6.4 mg/dL, p = 0.04).
Conclusion
A total of 20.0% of responders to intravenous steroid treatment for ASUC had a steroid dependency during follow-up. The demographic and clinical features of ASUC according to the presence or absence of steroid dependency were similar. Initial CRP levels were low in patients with steroid dependence.