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Predictive factors of response to intravenous ciclosporin in severe ulcerative colitis: the development of a novel prediction formula
Summary Background When treating patients with severe ulcerative colitis (UC), accurate prediction of drug efficacy contributes to early clinical decision‐making. Aim To identify predictive factors and to develop a reliable prediction formula and a decision tree of response to intravenous ciclospori...
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| Published in: | Alimentary pharmacology & therapeutics 2012-10, Vol.36 (8), p.744-754 |
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| container_title | Alimentary pharmacology & therapeutics |
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| creator | Saito, K. Katsuno, T. Nakagawa, T. Saito, M. Sazuka, S. Sato, T. Matsumura, T. Arai, M. Miyauchi, H. Matsubara, H. Yokosuka, O. |
| description | Summary
Background
When treating patients with severe ulcerative colitis (UC), accurate prediction of drug efficacy contributes to early clinical decision‐making.
Aim
To identify predictive factors and to develop a reliable prediction formula and a decision tree of response to intravenous ciclosporin treatment for severe UC.
Methods
Patients included in this study were those diagnosed with refractory severe UC who had undergone ciclosporin treatment between December 2004 and March 2011 at a tertiary referral centre in Japan. Demographic and clinical parameters from all patients were analysed by multivariate statistics.
Results
Fifty‐two patients were included in this study (36.5% men with an average age of ciclosporin initiation of 40.2 ± 15.6 years). Thirty‐four patients (65.4%) were responders to the treatment with ciclosporin and avoided colectomy, 18 patients (34.6%) were nonresponders and underwent colectomy. Stepwise multiple logistic regression analysis identified four independent predictive factors of response to intravenous ciclosporin: age at hospitalisation (AGE), platelet count (×104/μL) on the first day (PLA), Lichtiger score on the third day (LIC) and total protein (g/dL) on the third day minus total protein on the first day (ΔTP). The calculation formula (8.5 − 0.16 × AGE + 0.21 × PLA − 0.61 × LIC + 2.3 × ΔTP |
| doi_str_mv | 10.1111/apt.12033 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1041142030</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1041142030</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4283-c6eeaa0b585d4f19ed983b9838f94d2a5ce210f59c124a0c0c5ba208304a8dc43</originalsourceid><addsrcrecordid>eNp1kMtuFDEQRS0EIkNgwQ8gb5Bg0Ylf_WIXRWRAiSASQSytGndZGNztxnYPyQfw3ziZSVhhyXKp6tS98iXkJWdHvJxjmPMRF0zKR2TFZVNXpW4ekxUTTV-JjssD8iylH4yxpmXiKTkQoq_bXqkV-XMZcXAmuy1SCyaHmGiwNGKaw5SQ5kDdlCNscQpLosYZH8oouqn0acItRqSLNxjhTsME77JL72j-jnQoYx_mEad8Kwp0CqVB571lmKgNcVw8PCdPLPiEL_bvIfl69v7q9EN18Xn98fTkojJKdLIyDSIA29RdPSjLexz6Tm7K7WyvBgG1QcGZrXvDhQJmmKk3IFgnmYJuMEoekjc73TmGXwumrEeXDHoPE5bvac4U56qkxwr6doeaGFKKaPUc3QjxpkD6NnVdUtd3qRf21V522Yw4PJD3MRfg9R6AZMDbCJNx6R_XyLaRghfueMf9dh5v_u-oTy6v7q2r3YZLGa8fNiD-1E0r21p_-7TW9fq8U1_OuZbyL6vYqqs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1041142030</pqid></control><display><type>article</type><title>Predictive factors of response to intravenous ciclosporin in severe ulcerative colitis: the development of a novel prediction formula</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Saito, K. ; Katsuno, T. ; Nakagawa, T. ; Saito, M. ; Sazuka, S. ; Sato, T. ; Matsumura, T. ; Arai, M. ; Miyauchi, H. ; Matsubara, H. ; Yokosuka, O.</creator><creatorcontrib>Saito, K. ; Katsuno, T. ; Nakagawa, T. ; Saito, M. ; Sazuka, S. ; Sato, T. ; Matsumura, T. ; Arai, M. ; Miyauchi, H. ; Matsubara, H. ; Yokosuka, O.</creatorcontrib><description>Summary
Background
When treating patients with severe ulcerative colitis (UC), accurate prediction of drug efficacy contributes to early clinical decision‐making.
Aim
To identify predictive factors and to develop a reliable prediction formula and a decision tree of response to intravenous ciclosporin treatment for severe UC.
Methods
Patients included in this study were those diagnosed with refractory severe UC who had undergone ciclosporin treatment between December 2004 and March 2011 at a tertiary referral centre in Japan. Demographic and clinical parameters from all patients were analysed by multivariate statistics.
Results
Fifty‐two patients were included in this study (36.5% men with an average age of ciclosporin initiation of 40.2 ± 15.6 years). Thirty‐four patients (65.4%) were responders to the treatment with ciclosporin and avoided colectomy, 18 patients (34.6%) were nonresponders and underwent colectomy. Stepwise multiple logistic regression analysis identified four independent predictive factors of response to intravenous ciclosporin: age at hospitalisation (AGE), platelet count (×104/μL) on the first day (PLA), Lichtiger score on the third day (LIC) and total protein (g/dL) on the third day minus total protein on the first day (ΔTP). The calculation formula (8.5 − 0.16 × AGE + 0.21 × PLA − 0.61 × LIC + 2.3 × ΔTP < 0) predicted colectomy with an accuracy of 88.5% and the decision tree predicted colectomy with an accuracy of 90.4%.
Conclusion
The novel calculation formula and the decision tree effectively predict the clinical outcome of ciclosporin treatment for severe ulcerative colitis as early as on day 3 after starting ciclosporin treatment.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.12033</identifier><identifier>PMID: 22957944</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Administration, Intravenous ; Adolescent ; Adult ; Aged ; Biological and medical sciences ; Colitis, Ulcerative - drug therapy ; Cyclosporine - administration & dosage ; Digestive system ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Immunosuppressive Agents - administration & dosage ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Pharmacology. Drug treatments ; Predictive Value of Tests ; Severity of Illness Index ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Treatment Outcome ; Young Adult</subject><ispartof>Alimentary pharmacology & therapeutics, 2012-10, Vol.36 (8), p.744-754</ispartof><rights>2012 Blackwell Publishing Ltd</rights><rights>2015 INIST-CNRS</rights><rights>2012 Blackwell Publishing Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4283-c6eeaa0b585d4f19ed983b9838f94d2a5ce210f59c124a0c0c5ba208304a8dc43</citedby><cites>FETCH-LOGICAL-c4283-c6eeaa0b585d4f19ed983b9838f94d2a5ce210f59c124a0c0c5ba208304a8dc43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26376321$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22957944$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saito, K.</creatorcontrib><creatorcontrib>Katsuno, T.</creatorcontrib><creatorcontrib>Nakagawa, T.</creatorcontrib><creatorcontrib>Saito, M.</creatorcontrib><creatorcontrib>Sazuka, S.</creatorcontrib><creatorcontrib>Sato, T.</creatorcontrib><creatorcontrib>Matsumura, T.</creatorcontrib><creatorcontrib>Arai, M.</creatorcontrib><creatorcontrib>Miyauchi, H.</creatorcontrib><creatorcontrib>Matsubara, H.</creatorcontrib><creatorcontrib>Yokosuka, O.</creatorcontrib><title>Predictive factors of response to intravenous ciclosporin in severe ulcerative colitis: the development of a novel prediction formula</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
When treating patients with severe ulcerative colitis (UC), accurate prediction of drug efficacy contributes to early clinical decision‐making.
Aim
To identify predictive factors and to develop a reliable prediction formula and a decision tree of response to intravenous ciclosporin treatment for severe UC.
Methods
Patients included in this study were those diagnosed with refractory severe UC who had undergone ciclosporin treatment between December 2004 and March 2011 at a tertiary referral centre in Japan. Demographic and clinical parameters from all patients were analysed by multivariate statistics.
Results
Fifty‐two patients were included in this study (36.5% men with an average age of ciclosporin initiation of 40.2 ± 15.6 years). Thirty‐four patients (65.4%) were responders to the treatment with ciclosporin and avoided colectomy, 18 patients (34.6%) were nonresponders and underwent colectomy. Stepwise multiple logistic regression analysis identified four independent predictive factors of response to intravenous ciclosporin: age at hospitalisation (AGE), platelet count (×104/μL) on the first day (PLA), Lichtiger score on the third day (LIC) and total protein (g/dL) on the third day minus total protein on the first day (ΔTP). The calculation formula (8.5 − 0.16 × AGE + 0.21 × PLA − 0.61 × LIC + 2.3 × ΔTP < 0) predicted colectomy with an accuracy of 88.5% and the decision tree predicted colectomy with an accuracy of 90.4%.
Conclusion
The novel calculation formula and the decision tree effectively predict the clinical outcome of ciclosporin treatment for severe ulcerative colitis as early as on day 3 after starting ciclosporin treatment.</description><subject>Administration, Intravenous</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Colitis, Ulcerative - drug therapy</subject><subject>Cyclosporine - administration & dosage</subject><subject>Digestive system</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Pharmacology. Drug treatments</subject><subject>Predictive Value of Tests</subject><subject>Severity of Illness Index</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNp1kMtuFDEQRS0EIkNgwQ8gb5Bg0Ylf_WIXRWRAiSASQSytGndZGNztxnYPyQfw3ziZSVhhyXKp6tS98iXkJWdHvJxjmPMRF0zKR2TFZVNXpW4ekxUTTV-JjssD8iylH4yxpmXiKTkQoq_bXqkV-XMZcXAmuy1SCyaHmGiwNGKaw5SQ5kDdlCNscQpLosYZH8oouqn0acItRqSLNxjhTsME77JL72j-jnQoYx_mEad8Kwp0CqVB571lmKgNcVw8PCdPLPiEL_bvIfl69v7q9EN18Xn98fTkojJKdLIyDSIA29RdPSjLexz6Tm7K7WyvBgG1QcGZrXvDhQJmmKk3IFgnmYJuMEoekjc73TmGXwumrEeXDHoPE5bvac4U56qkxwr6doeaGFKKaPUc3QjxpkD6NnVdUtd3qRf21V522Yw4PJD3MRfg9R6AZMDbCJNx6R_XyLaRghfueMf9dh5v_u-oTy6v7q2r3YZLGa8fNiD-1E0r21p_-7TW9fq8U1_OuZbyL6vYqqs</recordid><startdate>201210</startdate><enddate>201210</enddate><creator>Saito, K.</creator><creator>Katsuno, T.</creator><creator>Nakagawa, T.</creator><creator>Saito, M.</creator><creator>Sazuka, S.</creator><creator>Sato, T.</creator><creator>Matsumura, T.</creator><creator>Arai, M.</creator><creator>Miyauchi, H.</creator><creator>Matsubara, H.</creator><creator>Yokosuka, O.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201210</creationdate><title>Predictive factors of response to intravenous ciclosporin in severe ulcerative colitis: the development of a novel prediction formula</title><author>Saito, K. ; Katsuno, T. ; Nakagawa, T. ; Saito, M. ; Sazuka, S. ; Sato, T. ; Matsumura, T. ; Arai, M. ; Miyauchi, H. ; Matsubara, H. ; Yokosuka, O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4283-c6eeaa0b585d4f19ed983b9838f94d2a5ce210f59c124a0c0c5ba208304a8dc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Administration, Intravenous</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Colitis, Ulcerative - drug therapy</topic><topic>Cyclosporine - administration & dosage</topic><topic>Digestive system</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Pharmacology. Drug treatments</topic><topic>Predictive Value of Tests</topic><topic>Severity of Illness Index</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saito, K.</creatorcontrib><creatorcontrib>Katsuno, T.</creatorcontrib><creatorcontrib>Nakagawa, T.</creatorcontrib><creatorcontrib>Saito, M.</creatorcontrib><creatorcontrib>Sazuka, S.</creatorcontrib><creatorcontrib>Sato, T.</creatorcontrib><creatorcontrib>Matsumura, T.</creatorcontrib><creatorcontrib>Arai, M.</creatorcontrib><creatorcontrib>Miyauchi, H.</creatorcontrib><creatorcontrib>Matsubara, H.</creatorcontrib><creatorcontrib>Yokosuka, O.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saito, K.</au><au>Katsuno, T.</au><au>Nakagawa, T.</au><au>Saito, M.</au><au>Sazuka, S.</au><au>Sato, T.</au><au>Matsumura, T.</au><au>Arai, M.</au><au>Miyauchi, H.</au><au>Matsubara, H.</au><au>Yokosuka, O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive factors of response to intravenous ciclosporin in severe ulcerative colitis: the development of a novel prediction formula</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2012-10</date><risdate>2012</risdate><volume>36</volume><issue>8</issue><spage>744</spage><epage>754</epage><pages>744-754</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background
When treating patients with severe ulcerative colitis (UC), accurate prediction of drug efficacy contributes to early clinical decision‐making.
Aim
To identify predictive factors and to develop a reliable prediction formula and a decision tree of response to intravenous ciclosporin treatment for severe UC.
Methods
Patients included in this study were those diagnosed with refractory severe UC who had undergone ciclosporin treatment between December 2004 and March 2011 at a tertiary referral centre in Japan. Demographic and clinical parameters from all patients were analysed by multivariate statistics.
Results
Fifty‐two patients were included in this study (36.5% men with an average age of ciclosporin initiation of 40.2 ± 15.6 years). Thirty‐four patients (65.4%) were responders to the treatment with ciclosporin and avoided colectomy, 18 patients (34.6%) were nonresponders and underwent colectomy. Stepwise multiple logistic regression analysis identified four independent predictive factors of response to intravenous ciclosporin: age at hospitalisation (AGE), platelet count (×104/μL) on the first day (PLA), Lichtiger score on the third day (LIC) and total protein (g/dL) on the third day minus total protein on the first day (ΔTP). The calculation formula (8.5 − 0.16 × AGE + 0.21 × PLA − 0.61 × LIC + 2.3 × ΔTP < 0) predicted colectomy with an accuracy of 88.5% and the decision tree predicted colectomy with an accuracy of 90.4%.
Conclusion
The novel calculation formula and the decision tree effectively predict the clinical outcome of ciclosporin treatment for severe ulcerative colitis as early as on day 3 after starting ciclosporin treatment.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>22957944</pmid><doi>10.1111/apt.12033</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Administration, Intravenous Adolescent Adult Aged Biological and medical sciences Colitis, Ulcerative - drug therapy Cyclosporine - administration & dosage Digestive system Female Gastroenterology. Liver. Pancreas. Abdomen Humans Immunosuppressive Agents - administration & dosage Male Medical sciences Middle Aged Other diseases. Semiology Pharmacology. Drug treatments Predictive Value of Tests Severity of Illness Index Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Treatment Outcome Young Adult |
| title | Predictive factors of response to intravenous ciclosporin in severe ulcerative colitis: the development of a novel prediction formula |
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