Treatment patterns and outcomes in patients with steroid-dependent ulcerative colitis in Japan: a claims database study.

IF 4.7 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2026-04-01 Epub Date: 2025-11-13 DOI:10.5217/ir.2025.00032

Masayuki Saruta, Takumi Sugiyama, Takumi Tajima, Chisa Nagakura, Yan Zhong, Toshihiko Kaise

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引用次数: 0

Abstract

Background/aims: Guidelines recommend that steroid treatment for ulcerative colitis (UC) is tapered or withdrawn within 3 months of initiation, and thiopurine treatment or advanced therapy is administered for steroid-dependent UC. This study aimed to clarify real-world treatment patterns and outcomes in patients with steroid-dependent UC in Japan.

Methods: A retrospective analysis of JMDC (Japan Medical Data Center) claims data was conducted to identify patients with a new UC diagnosis between June 2010 and September 2019. Index dates were the UC treatment start date (initiation of any UC treatment), steroid dependence/resistance confirmation date (identification of steroid-dependent UC), and treatment intensification date (initiation of thiopurine treatment/advanced therapy).

Results: Of 5,602 patients with newly diagnosed UC, 986 (17.6%) initiated steroids within 12 months (85.4% [842/986] received 5-aminosalicylic acid at the UC treatment start date). Of these 986 patients, 429 (43.5%) were classified as steroid-dependent (steroid dependence/resistance confirmation date). Of these 429 patients, 128 (29.8%) initiated thiopurine treatment and 75 (17.5%) initiated advanced therapy (treatment intensification date); 226 (52.7%) continued with steroids only. Across these groups, 3-6% discontinued steroids within 3 months of initiation. Hospitalization due to UC in the 12 months after the treatment intensification date occurred in 24.2% (31/128) and 18.7% (14/75) of patients who initiated thiopurine and advanced therapy, respectively.

Conclusions: Over half of patients with steroid-dependent UC continued steroid treatment only. Steroid discontinuation within 3 months of initiation was low, irrespective of whether thiopurines or advanced therapy were initiated. Management of patients with steroid-dependent UC in Japan requires further treatment optimization toward guideline adherence.

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日本类固醇依赖性溃疡性结肠炎患者的治疗模式和结果：一项索赔数据库研究。

背景/目的：指南建议溃疡性结肠炎（UC）的类固醇治疗在开始治疗3个月内逐渐减少或停止，对类固醇依赖性UC进行硫嘌呤治疗或高级治疗。本研究旨在阐明日本类固醇依赖性UC患者的现实治疗模式和结果。方法：回顾性分析日本医疗数据中心（JMDC）的索赔数据，以确定2010年6月至2019年9月期间新诊断为UC的患者。指标日期为UC治疗开始日期（开始任何UC治疗），类固醇依赖/耐药性确认日期（确定类固醇依赖性UC）和治疗强化日期（开始硫嘌呤治疗/高级治疗）。结果：在5602例新诊断的UC患者中，986例（17.6%）在12个月内开始使用类固醇（85.4%[842/986]在UC治疗开始日接受5-氨基水杨酸治疗）。在这986例患者中，429例（43.5%）被归类为类固醇依赖（类固醇依赖/耐药确认日期）。在这429例患者中，128例（29.8%）开始了硫嘌呤治疗，75例（17.5%）开始了高级治疗（治疗强化日期）；226例（52.7%）继续仅使用类固醇。在这些组中，3-6%的人在开始治疗的3个月内停止使用类固醇。在强化治疗后12个月内因UC住院的患者分别为24.2%（31/128）和18.7%（14/75）。结论：超过一半的类固醇依赖性UC患者继续仅接受类固醇治疗。无论是否开始使用硫嘌呤或高级治疗，3个月内类固醇停药率很低。在日本，类固醇依赖性UC患者的管理需要进一步优化治疗，以遵循指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.