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. 2026 Jan 19;11(1):90-99.
doi: 10.1159/000550219. eCollection 2026 Jan-Dec.

Effectiveness of Intravenous Corticosteroid in Patients with Ulcerative Colitis after Oral Corticosteroid Failure: Differences by Prior Response to Oral Therapy in a Multicenter Cohort Study

Tomohiro Fukuda  1   2 , Kenji Tatsumi  3 , Naoko Inagaki  4   5 , Aya Ikeda  4 , Noriyuki Ogata  6 , Jun Kanazawa  7 , Yoshinori Nakamori  8 , Toshiyuki Endo  9 , Hirosuke Kuroki  3 , Yuichiro Kuroki  10 , Takashi Ueda  11 , Atsushi Yoshida  12 ; Kanagawa IBD Study Group
Affiliations

Effectiveness of Intravenous Corticosteroid in Patients with Ulcerative Colitis after Oral Corticosteroid Failure: Differences by Prior Response to Oral Therapy in a Multicenter Cohort Study

Tomohiro Fukuda et al. Inflamm Intest Dis. .

Abstract

Introduction: Moderate-to-severe ulcerative colitis (UC) is commonly treated with oral corticosteroids. However, in cases of oral corticosteroid failure, no clear consensus exists on whether to transition to intravenous corticosteroids (IVCS) or initiate advanced therapies. The aim of this study was to evaluate whether responsiveness to oral corticosteroids is associated with differences in the efficacy of IVCS.

Methods: This multicenter cohort study (conducted at 10 facilities) included patients with moderate-to-severe UC who were transitioned to IVCS after failure of oral corticosteroid therapy. The patients were categorized into the partial responder and nonresponder groups based on their response to oral corticosteroids, as measured by improvements in their PRO-2 scores. The primary outcome was clinical remission at day 30, defined as a total PRO-2 score ≤1 with a rectal bleeding subscore of 0. Logistic regression was used to estimate the odds ratio (OR) of achieving clinical remission.

Results: A total of 123 patients with UC were included, with 41 and 82 patients in the partial responder and nonresponder groups, respectively. Clinical remission at day 30 was achieved in 41.4% of the partial responders and 18.3% of the nonresponders (multivariable-adjusted OR, 0.35 [95% CI: 0.15-0.83]; p = 0.017). The nonresponder group had a higher risk of requiring advanced therapies within 90 days than the partial responder group (multivariable-adjusted OR, 2.48 [95% CI: 1.09-5.66]; p = 0.030).

Conclusions: In patients with UC and oral corticosteroid failure, responsiveness to oral corticosteroids may be associated with differences in IVCS efficacy.

Keywords: Cohort study; Corticosteroids; Inflammatory bowel disease; Treatment response; Ulcerative colitis.

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Conflict of interest statement

N.O. received honoraria from Takeda Pharma, Mitsubishi Tanabe Pharma, EA Pharma, AbbVie GK, Mochida Pharma, Zeria Pharma, and Nippon Kayaku. A.Y. received personal fees from Mitsubishi Tanabe Pharma, Janssen Pharmaceutical K.K., AbbVie Inc., EA Pharma Co., Ltd., Nippon Kayaku Co. Ltd., Takeda Pharmaceutical Co. Ltd., Pfizer Inc., and Mochida Pharmaceutical Co., Ltd. T.F., K.T., N.I., A.I., J.K., Y.N., T.E., H.K., Y.K., and T.U. have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Participant flowchart. A total of 123 patients were included in the analysis and categorized into two groups: partial responder group and nonresponder group.
Fig. 2.
Fig. 2.
Kaplan-Meier curves of survival for patients requiring advanced therapy in the partial responder and nonresponder groups.
Fig. 3.
Fig. 3.
Kaplan-Meier curves of survival for patients requiring colectomy in the partial responder and nonresponder groups.
See this image and copyright information in PMC

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