Prescriber Practices and Their Impact on Recurrence Rates in Microscopic Colitis

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Am J Gastroenterol

Abstract

Introduction: Microscopic colitis (MC) is a challenging disease to manage due to the high likelihood of disease recurrence following initial treatment. Some studies have shown that up to 80% of patients initially treated with budesonide experience symptoms within 3 months of stopping the medication. This study aimed to examine how various initial treatments prescribed for patients with newly diagnosed MC impact rates of short-term disease recurrence. Methods: A retrospective cohort study was conducted at a single, urban quaternary care center in the midwestern United States and consisted of 176 patients who presented in the ambulatory setting and received a new histologic diagnosis of MC. Data points that were collected including various patient demographics and initial treatment prescribed. Primary outcome measured was recurrence of symptoms, defined as lack of sustained treatment response following initial therapy and re-presentation to the gastroenterology clinic within 1 year following initial treatment. Results: 59 (34%) patients were treated initially with a budesonide 2-month taper and 53 (30%) patients were treated with a fixed daily dose of budesonide defined as a 2-month course. Additional treatments included 22 (12%) patients who received loperamide, 2 (5%) patients who received bismuth subsalicylate and 3 (8%) patients who received bile acid sequestrants. Other treatments included prednisone, sulfasalazine, and diphenoxylate/atropine which were prescribed in 7 (19%) of patients. A total of 40 (23%) patients who were treated with these medications experienced short-term recurrence of symptoms. A univariate analysis revealed no significant association between initial therapy attempted and frequency of recurrence (Table 1). Conclusion: This study found that the choice of initial treatment does not seem to impact symptom recurrence rates in patients with MC. This suggests that clinicians may tailor their initial choice of therapy to each patient while considering factors such as potential drug interactions and financial constraints without being concerned about decreased efficacy. These findings would benefit from validation on a larger scale since most patients in our cohort received initial treatment with budesonide while other treatments were prescribed far more infrequently. (Table Presented).

Volume

119

Issue

10

First Page

S219

Last Page

S220

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