Steroid complications in patients with ulcerative colitis

Kusunoki, Masato; Möeslein, Gabriela; Shoji, Yasutsugu; Fujita, Shinsuke; Yanagi, Hidenori; Sakanoue, Youichirou; Saito, Naoaki; Utsunomiya, Joji

doi:10.1007/bf02253508

Cited by 45 publications

(32 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Glucocorticoid (GC) treatment can be effective on ulcerative colitis (UC) [1] , however, in relapsed cases, the conditions are frequently refractory even when a high dosage of GC is administered [2,3] . It is well known that a long-term use of GC often causes serious side effects [4] . It would be useful if the responsiveness of patients to GC could be evaluated before the administration.…”

Section: Introductionmentioning

confidence: 99%

Significance of glucocorticoid receptor expression in colonic mucosal cells of patients with ulcerative colitis

Ouyang²,

Wen³

et al. 2005

WJG

View full text Add to dashboard Cite

AIM: Glucocorticoid (GC) resistant ulcerative colitis (UC) remains a serious disease and is difficult to manage. Although the molecular basis of GC insensitivity is still unknown, GC receptors (GR and GR) may play an important role in it. This study was aimed to investigate the relationship between the expression of GR and GR in colonic mucosal cells of patients with UC, the efficacy of GC therapy and the intensity of inflammation. METHODS:Twenty-five cases of UC were classified into: GC sensitive (n = 16) and GC resistant (n = 9) cases. Patients consisted of mild (n = 6), moderate (n = 8) and severe (n = 11) cases. GR and GR expression in colonic mucosal specimens were investigated by immunohistochemistry, and compared between GC resistant and sensitive groups, and also among various degrees of inflammation. RESULTS:All cases were positive for GR and GR expression. Both positive association between GR expression and the response of UC to GC and strong negative association between GR expression and the response of UC to GC were identified. There was no significant association between GR/GR expression and the degree of inflammation of UC. CONCLUSION:These findings suggest that both GR and GR may play an important role in the action of GC, and that GR functions as a dominant negative inhibitor of GR. Expression of GR and GR in colonic mucosal cells of patients with UC may serve as predictors of glucocorticoid response, but can not function as markers of inflammatory intensity.

show abstract

Section: Introductionmentioning

confidence: 99%

Significance of glucocorticoid receptor expression in colonic mucosal cells of patients with ulcerative colitis

Ouyang²,

Wen³

et al. 2005

WJG

View full text Add to dashboard Cite

show abstract

“…20 c-GCS, when administered for either therapy of active disease or maintenance treatment of UC or CD, may lead to severe steroid side-effects. 5,21 In other studies, patients with chronic active or frequently relapsing disease have been treated with azathioprine or 6-mercaptopurine, leading to complete remission in many cases and allowing termination of therapy with corticosteroids. 22,23 In UC, azathioprine maintenance treatment was shown to be bene®cial for at least 2 years in cases where remission had been achieved within 6 months of initiation of therapy.…”

Section: Discussionmentioning

confidence: 99%

“…5 The most serious side-effects, some of which are irreversible, are associated with long-term treatment. In some cases of Crohn's disease (CD) and UC, reduction or cessation of conventional GCS (c-GCS) treatment leads to relapse.…”

Section: Introductionmentioning

confidence: 99%

Oral budesonide therapy for steroid‐dependent ulcerative colitis: a pilot trial

Keller¹,

Stoll²,

Foerster³

et al. 1997

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Background:Budesonide, a corticosteroid with high topical anti‐inflammatory activity and low systemic activity, has been shown to prolong time to relapse in Crohn's disease. In the present study, the efficacy of budesonide in an oral pH‐modified‐release formulation was evaluated for maintenance treatment in patients with steroid‐dependent ulcerative colitis.Methods:Fourteen patients with steroid‐dependent ulcerative colitis in the reduction phase of conventional glucocorticosteroids (c‐GCS) following a severe attack, were treated with budesonide 3 mg t.d.s. for 6 months. The primary investigation parameters were changes in the clinical activity index (CAI) and in the daily dose of c‐GCS.Results:In 11 cases the CAI improved significantly and treatment with c‐GCS could be terminated. Three patients experienced relapse and needed further c‐GCS treatment. The average daily dose of c‐GCS and the average value of the CAI before treatment with budesonide were significantly higher in the relapse group than in the remission group.Conclusions:In patients with c‐GCS‐dependent ulcerative colitis, a dose of 9 mg budesonide daily in an oral pH‐modified‐release formulation was well tolerated, significantly decreased the CAI, and rendered c‐GCS unnecessary in the majority of cases.

show abstract

“…Until ten years ago, high total PDN doses were administered before surgery and this was strongly associated with incidence of SSI in patients with UC, especially in Japanese institutes (22)(23)(24)(25). Use of nonsteroid drugs, including immunomodulators and antitumor necrosis factor, has recently been increasing in pediatric patients with a hopeful future, though corticosteroids remain the main drug for inducing remission of UC.…”

Section: Discussionmentioning

confidence: 99%