What is the efficacy of treatments for ulcerative colitis (UC)?

Updated: Oct 02, 2017
  • Author: David A Piccoli, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

A study by Hyams et al that evaluated 416 children 12 weeks after they were treated for ulcerative colitis with mesalazine (132 children), oral corticosteroids (141), or intravenous corticosteroids (143) reported that at week 12, corticosteroid-free remission was achieved by 64 (48%) patients in the mesalazine group, 47 (33%) in the oral corticosteroid group, and 30 (21%) in the intravenous corticosteroid group (p<0·0001). Seven percent of patients in the mesalazine group, 15% in the oral corticosteroid group, and 36% in the intravenous corticosteroid group required treatment escalation. Eight patients who were first treated with intravenous corticosteroids underwent colectomy. Factors that predicted remission at 12 weeks included a Pediatric Ulcerative Colitis Activity Index score of less than 35, higher baseline albumin by 1 g/dL increments among children younger than 12 years, and week 4 remission. The study also reported that predictors of treatment escalation by week 12 in patients initially treated with intravenous corticosteroids included baseline total Mayo score of 11 or higher, rectal biopsy eosinophil count less than or equal to 32 cells per high power field, rectal biopsy surface villiform changes, and not achieving week 4 remission. [28]


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