Smoking Can Reduce Treatment Response in Microscopic Colitis

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Am J Gastroenterol

Abstract

Introduction: While existing research has focused on the association of specific risk factors with the development of microscopic colitis (MC), investigation of determinants affecting treatment response for MC patients is limited. The study aims to analyze whether certain risk factors affect treatment response in patients receiving initial therapy for MC. Methods: A retrospective cohort study was conducted at a single urban quaternary care center and consisted of 176 patients that received a new diagnosis of MC in the ambulatory setting. Demographic data, chronic medication use, comorbidities, and smoking status were collected for each patient. Patients received initial treatment and their daily number of bowel movements were recorded before and after therapy. Their response to treatment was the primary outcome. Treatment response was recorded as remission (complete resolution), partial response (>50% response), non-response (< 50% response), or intolerance due to medication side effect. Results: In total, 58 patients (33% of total cohort) achieved clinical remission while 90 (51%) had a partial response and 25 (14%) patients had no response to treatment. An additional 3 (2%) patients had intolerance to initial treatment. A univariate analysis assessing individual risk factors revealed that patients who were actively smoking had a significantly higher frequency of non-response to initial therapy (22%) compared to non-smokers (10%) (P = 0.007). No other risk factors studied had a significant effect on response to initial treatment in MC. Conclusion: This study demonstrates an association between active smoking and poor response to initial treatment in patients with MC. While active smoking is a known risk factor for the development of MC, this study reveals that smoking cessation is also a key component in achieving successful remission of this disease process. Further prospective multicenter studies are needed to explore the relationship between smoking and decreased treatment response and to minimize confounding variables. (Table Presented).

Volume

119

Issue

10

First Page

S219

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