title: The possible utility of steroids in the prevention of relapses of Crohn's disease in remission. A preliminary study.
abstract: In Crohn's disease, prednisone is believed to be ineffective for relapse prevention. Because all patients with Crohn's Disease Activity Index lower than 150 and with some altered lab tests (erythrocyte sedimentation rate, C-reactive protein, alpha-1-acid glycoprotein, alpha-1-acid antitrypsin, and white blood cell count) had a clinical relapse in 18 months of follow-up, we tried to ascertain whether methylprednisolone could reduce the risk of clinical relapse in such patients. Eighteen patients were included in a controlled study against placebo. Nine patients were treated with methylprednisolone at a dosage of 0.25 mg/kg daily for a period of 6 months; treatment was discontinued if disease relapsed or if lab tests were normalized. During the steroid treatment, 1 of 9 patients showed a clinical relapse; in 7, the normalization of lab tests was obtained; in 5 of these 7 patients a relapse occurred within 1 month after the suspension of the treatment; in 1 patient, lab tests remained altered. In those 9 patients on placebo, relapses occurred in 7. We conclude that methylprednisolone was effective in the prevention of relapses for patients in clinical remission but with altered lab tests.
authors.affiliation: Istituto di Clinica Medica e Gastroenterologia, Universita di Bologna, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Brignola
authors.forename: M
authors.initials: M
authors.lastname: Campieri
authors.forename: P
authors.initials: P
authors.lastname: Farruggia
authors.forename: A
authors.initials: A
authors.lastname: Tragnone
authors.forename: S
authors.initials: S
authors.lastname: Pasquali
authors.forename: P
authors.initials: P
authors.lastname: Iannone
authors.forename: G A
authors.initials: GA
authors.lastname: Lanfranchi
authors.forename: L
authors.initials: L
authors.lastname: Barbara
mesh_terms: D000328:Adult; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D011897:Random Allocation; D012008:Recurrence
chemical_list: D002097:C-Reactive Protein; D008775:Methylprednisolone