title: Corticosteroid therapy in ulcerative colitis: Clinical response and predictors.
abstract: OBJECTIVE
  To evaluate clinical response to initial corticosteroid (CS) treatment in Chinese ulcerative colitis patients (UC) and identify predictors of clinical response.
  
  
  METHODS
  Four hundred and twenty-three UC patients who were initially treated with oral or intravenous CS from 2007 to 2011 were retrospectively reviewed at eight inflammatory bowel disease centers in China, and 101 consecutive cases with one-year follow-up were analyzed further for clinical response and predictors. Short-term outcomes within one month were classified as primary response and primary non-response. Long-term outcomes within one year were classified as prolonged CS response, CS dependence and secondary non-response. CS refractoriness included primary and secondary non-response. Multivariate analyses were performed to identify predictors associated with clinical response.
  
  
  RESULTS
  Within one month, 95.0% and 5.0% of the cases were classified into primary response and non-response, respectively. Within one year, 41.6% of cases were assessed as prolonged CS response, while 49.5% as CS dependence and 4.0% as secondary non-response. The rate of CS refractoriness was 8.9%, while the cumulative rate of surgery was 6.9% within one year. After multivariate analysis of all the variables, tenesmus was found to be a negative predictor of CS dependence (OR = 0.336; 95%CI: 0.147-0.768; P = 0.013) and weight loss as a predictor of CS refractoriness (OR = 5.662; 95%CI: 1.111-28.857; P = 0.040). After one-month treatment, sustained high Sutherland score (≥ 6) also predicted CS dependence (OR = 2.347; 95%CI: 0.935-5.890; P = 0.014).
  
  
  CONCLUSIONS
  Tenesmus was a negative predictor of CS dependence, while weight loss and sustained high Sutherland score were strongly associated with poor CS response.
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Li
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Wang
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Hong-Jie
authors.initials: HJ
authors.lastname: Zhang
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Jian-Qiu
authors.initials: JQ
authors.lastname: Sheng
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Wen-Feng
authors.initials: WF
authors.lastname: Yan
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Min-Xing
authors.initials: MX
authors.lastname: Ma
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Ru-Ying
authors.initials: RY
authors.lastname: Fan
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Gu
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Chuan-Feng
authors.initials: CF
authors.lastname: Li
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Da-Fan
authors.initials: DF
authors.lastname: Chen
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zheng
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Yu-Pei
authors.initials: YP
authors.lastname: Gu
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Cao
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yang
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Jia-Ming
authors.initials: JM
authors.lastname: Qian
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Pin-Jin
authors.initials: PJ
authors.lastname: Hu
authors.affiliation: Jin Li, Fan Wang, Wen-Feng Yan, Min-Xing Ma, Bing Xia, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Xia
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D016009:Chi-Square Distribution; D002681:China; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Clinical response; Corticosteroid; Predictor; Ulcerative colitis