Outcomes of patients with microscopic colitis treated with corticosteroids: A population-based study

Nicole M. Gentile, Adil A. Abdalla, Sahil Khanna, Thomas Christopher Smyrk, William J. Tremaine, William Alvis Faubion, Patricia P. Kammer, William J. Sandborn, Edward Vincent Loftus, Jr, Darrell S. Pardi

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Abstract

OBJECTIVES:To evaluate the outcomes of corticosteroid-treated microscopic colitis (MC) in a population-based cohort, and to compare these outcomes in patients treated with prednisone or budesonide.METHODS:A historical cohort study of Olmsted County, Minnesota residents diagnosed with collagenous or lymphocytic colitis (LC) between 1986 and 2010 was performed using the Rochester Epidemiology Project.RESULTS:Of 315 patients with MC, 80 (25.4%) were treated with corticosteroids. The median age at colitis diagnosis was 66.5 years (range: 16-95) and 78.7% were female. Forty patients (50%) had LC and 40 (50%) had collagenous colitis. Prednisone was used in 17 patients (21.2%) and budesonide in 63 (78.8%); 56 (75.6%) had complete response and 15 (20.3%) had partial response. Patients treated with budesonide had a higher rate of complete response than those treated with prednisone (82.5 vs. 52.9%; odds ratio, 4.18; 95% CI, 1.3-13.5). Six patients were lost to follow-up. The remaining 74 had a median follow-up of 4 years (range 0.2-14). Fifty patients out of the 71 who responded (70.4%) had a recurrence after corticosteroid discontinuation. Patients treated with budesonide were less likely to recur than those treated with prednisone (hazard ratio, 0.38; 95% CI, 0.18-0.85; P=0.02). After 397 person years of follow-up in the 73 patients with long-term data, 47 (64.4%) required maintenance with corticosteroids.CONCLUSION:Patients with MC often respond to corticosteroid therapy, but with a high relapse rate. Budesonide had a higher response rate and a lower risk of recurrence than prednisone.

Original languageEnglish (US)
Pages (from-to)256-259
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume108
Issue number2
DOIs
StatePublished - Feb 2013

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Microscopic Colitis
Adrenal Cortex Hormones
Budesonide
Prednisone
Population
Lymphocytic Colitis
Collagenous Colitis
Recurrence
Lost to Follow-Up
Colitis
Epidemiology
Cohort Studies

ASJC Scopus subject areas

  • Gastroenterology

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Outcomes of patients with microscopic colitis treated with corticosteroids : A population-based study. / Gentile, Nicole M.; Abdalla, Adil A.; Khanna, Sahil; Smyrk, Thomas Christopher; Tremaine, William J.; Faubion, William Alvis; Kammer, Patricia P.; Sandborn, William J.; Loftus, Jr, Edward Vincent; Pardi, Darrell S.

In: American Journal of Gastroenterology, Vol. 108, No. 2, 02.2013, p. 256-259.

Research output: Contribution to journalArticle

Gentile, NM, Abdalla, AA, Khanna, S, Smyrk, TC, Tremaine, WJ, Faubion, WA, Kammer, PP, Sandborn, WJ, Loftus, Jr, EV & Pardi, DS 2013, 'Outcomes of patients with microscopic colitis treated with corticosteroids: A population-based study', American Journal of Gastroenterology, vol. 108, no. 2, pp. 256-259. https://doi.org/10.1038/ajg.2012.416
Gentile, Nicole M. ; Abdalla, Adil A. ; Khanna, Sahil ; Smyrk, Thomas Christopher ; Tremaine, William J. ; Faubion, William Alvis ; Kammer, Patricia P. ; Sandborn, William J. ; Loftus, Jr, Edward Vincent ; Pardi, Darrell S. / Outcomes of patients with microscopic colitis treated with corticosteroids : A population-based study. In: American Journal of Gastroenterology. 2013 ; Vol. 108, No. 2. pp. 256-259.
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abstract = "OBJECTIVES:To evaluate the outcomes of corticosteroid-treated microscopic colitis (MC) in a population-based cohort, and to compare these outcomes in patients treated with prednisone or budesonide.METHODS:A historical cohort study of Olmsted County, Minnesota residents diagnosed with collagenous or lymphocytic colitis (LC) between 1986 and 2010 was performed using the Rochester Epidemiology Project.RESULTS:Of 315 patients with MC, 80 (25.4{\%}) were treated with corticosteroids. The median age at colitis diagnosis was 66.5 years (range: 16-95) and 78.7{\%} were female. Forty patients (50{\%}) had LC and 40 (50{\%}) had collagenous colitis. Prednisone was used in 17 patients (21.2{\%}) and budesonide in 63 (78.8{\%}); 56 (75.6{\%}) had complete response and 15 (20.3{\%}) had partial response. Patients treated with budesonide had a higher rate of complete response than those treated with prednisone (82.5 vs. 52.9{\%}; odds ratio, 4.18; 95{\%} CI, 1.3-13.5). Six patients were lost to follow-up. The remaining 74 had a median follow-up of 4 years (range 0.2-14). Fifty patients out of the 71 who responded (70.4{\%}) had a recurrence after corticosteroid discontinuation. Patients treated with budesonide were less likely to recur than those treated with prednisone (hazard ratio, 0.38; 95{\%} CI, 0.18-0.85; P=0.02). After 397 person years of follow-up in the 73 patients with long-term data, 47 (64.4{\%}) required maintenance with corticosteroids.CONCLUSION:Patients with MC often respond to corticosteroid therapy, but with a high relapse rate. Budesonide had a higher response rate and a lower risk of recurrence than prednisone.",
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T1 - Outcomes of patients with microscopic colitis treated with corticosteroids

T2 - A population-based study

AU - Gentile, Nicole M.

AU - Abdalla, Adil A.

AU - Khanna, Sahil

AU - Smyrk, Thomas Christopher

AU - Tremaine, William J.

AU - Faubion, William Alvis

AU - Kammer, Patricia P.

AU - Sandborn, William J.

AU - Loftus, Jr, Edward Vincent

AU - Pardi, Darrell S.

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N2 - OBJECTIVES:To evaluate the outcomes of corticosteroid-treated microscopic colitis (MC) in a population-based cohort, and to compare these outcomes in patients treated with prednisone or budesonide.METHODS:A historical cohort study of Olmsted County, Minnesota residents diagnosed with collagenous or lymphocytic colitis (LC) between 1986 and 2010 was performed using the Rochester Epidemiology Project.RESULTS:Of 315 patients with MC, 80 (25.4%) were treated with corticosteroids. The median age at colitis diagnosis was 66.5 years (range: 16-95) and 78.7% were female. Forty patients (50%) had LC and 40 (50%) had collagenous colitis. Prednisone was used in 17 patients (21.2%) and budesonide in 63 (78.8%); 56 (75.6%) had complete response and 15 (20.3%) had partial response. Patients treated with budesonide had a higher rate of complete response than those treated with prednisone (82.5 vs. 52.9%; odds ratio, 4.18; 95% CI, 1.3-13.5). Six patients were lost to follow-up. The remaining 74 had a median follow-up of 4 years (range 0.2-14). Fifty patients out of the 71 who responded (70.4%) had a recurrence after corticosteroid discontinuation. Patients treated with budesonide were less likely to recur than those treated with prednisone (hazard ratio, 0.38; 95% CI, 0.18-0.85; P=0.02). After 397 person years of follow-up in the 73 patients with long-term data, 47 (64.4%) required maintenance with corticosteroids.CONCLUSION:Patients with MC often respond to corticosteroid therapy, but with a high relapse rate. Budesonide had a higher response rate and a lower risk of recurrence than prednisone.

AB - OBJECTIVES:To evaluate the outcomes of corticosteroid-treated microscopic colitis (MC) in a population-based cohort, and to compare these outcomes in patients treated with prednisone or budesonide.METHODS:A historical cohort study of Olmsted County, Minnesota residents diagnosed with collagenous or lymphocytic colitis (LC) between 1986 and 2010 was performed using the Rochester Epidemiology Project.RESULTS:Of 315 patients with MC, 80 (25.4%) were treated with corticosteroids. The median age at colitis diagnosis was 66.5 years (range: 16-95) and 78.7% were female. Forty patients (50%) had LC and 40 (50%) had collagenous colitis. Prednisone was used in 17 patients (21.2%) and budesonide in 63 (78.8%); 56 (75.6%) had complete response and 15 (20.3%) had partial response. Patients treated with budesonide had a higher rate of complete response than those treated with prednisone (82.5 vs. 52.9%; odds ratio, 4.18; 95% CI, 1.3-13.5). Six patients were lost to follow-up. The remaining 74 had a median follow-up of 4 years (range 0.2-14). Fifty patients out of the 71 who responded (70.4%) had a recurrence after corticosteroid discontinuation. Patients treated with budesonide were less likely to recur than those treated with prednisone (hazard ratio, 0.38; 95% CI, 0.18-0.85; P=0.02). After 397 person years of follow-up in the 73 patients with long-term data, 47 (64.4%) required maintenance with corticosteroids.CONCLUSION:Patients with MC often respond to corticosteroid therapy, but with a high relapse rate. Budesonide had a higher response rate and a lower risk of recurrence than prednisone.

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