Clinical Outcomes and Predictive Factors for Response after the First Course of Corticosteroid Therapy in Patients with Crohn's Disease

Kim, Duk Hwan; Cheon, Jae Hee; Park, Jae Jun; Yoon, Jin Young; Moon, Chang Mo; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho

Abstract

BACKGROUND/AIMS
This study sought to determine the natural course of Crohn's disease (CD) and identify predictors that could indicate responsiveness to corticosteroid (CS) therapy.
METHODS
Patients with active CD who were treated with oral CS at a single institution between August 1994 and February 2008 were retrospectively reviewed. The clinical outcomes at 1 month, 4 months, and 1 year after the treatment, as well as clinical and biochemical parameters at the time of CS initiation, were evaluated.
RESULTS
A total of 96 patients with CD were enrolled. In this study, 37 patients achieved complete remission (38.5%), 49 achieved partial remission (51.0%), and 10 (10.4%) showed no response at 1 month after the initiation of CS treatment. At 4 months and 1 year after treatment, 66 (69.5%) and 47 (56.6%) patients showed prolonged response, 22 (23.2%) and 20 (24.1%) showed steroid dependency, and 7 (7.4%) and 16 (19.3%) showed refractoriness, respectively. Nonstricturing and nonpenetrating behaviors and a lower CD activity index demonstrated clinical significance for mid-term or mid- and long-term steroid responses, respectively.
CONCLUSIONS
The short-term response rate to initial oral CS therapy in CD was considerably high, but responsiveness thereafter showed a tendency to decrease with time. Clinical parameters reflecting mild inflammation were associated with responsiveness after CS treatment.