A comparison of intravenous methylprednisolone and hydrocortisone for the treatment of acute inflammatory bowel disease
| Autor: | Michael T.M. Wang, Michael Chieng, Cameron Schauer, Mark Lane, Victoria Avery, Paras Garg, Charlotte Rowan, Anurag Sekra, Russell S. Walmsley, Sam Seleq |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Hydrocortisone medicine.drug_class medicine.medical_treatment Hypokalemia Inflammatory bowel disease Methylprednisolone Cohort Studies 03 medical and health sciences 0302 clinical medicine Interquartile range Adrenal Cortex Hormones Internal medicine medicine Humans Hepatology business.industry Gastroenterology Bowel resection Odds ratio medicine.disease Colitis Inflammatory Bowel Diseases Ulcerative colitis 030220 oncology & carcinogenesis Acute Disease Corticosteroid 030211 gastroenterology & hepatology Colitis Ulcerative medicine.symptom business Cohort study |
| Zdroj: | Journal of gastroenterology and hepatologyReferences. 36(10) |
| ISSN: | 1440-1746 |
| Popis: | BACKGROUND AND AIM Despite widespread recommendations and use of intravenous corticosteroids (IVCS) for the treatment of acute flares of ulcerative colitis and Crohn's disease, limited evidence exists comparing outcomes of the two most common regimens, intravenous methylprednisolone (IVMP) and intravenous hydrocortisone (IVHC). IVHC has stronger mineralocorticoid effects compared with IVMP and may cause higher rates of hypokalemia. We aimed to determine differences in clinical outcomes including requirement for inpatient rescue therapy, bowel resection, and rates of hypokalemia. METHODS We conducted a multicenter cohort study of all adult patients admitted with an acute flare of inflammatory bowel disease (IBD) to the three tertiary hospitals in Auckland, New Zealand, where the protocol at each institution is either IVMP 60 mg daily or IVHC 100 mg four times daily. All patients requiring IVCS between 20 June 2016 and 30 June 2018 were included. The IVCS protocol was then changed at one hospital, where further data were collected for a further 12 months from 30 January 2019 until 30 December 2019. RESULTS There were 359 patients, including 129 (35.9%) patients receiving IVMP and 230 (64.1%) patients receiving IVHC. IVMP treatment was associated with a greater requirement for rescue therapy than IVHC (36.4% vs 19.6%, P = 0.001; odds ratio [OR] = 2.79; 95% confidence interval [CI], 1.64-4.75, P |
| Databáze: | OpenAIRE |
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