Intravenous steroids for ulcerative colitis

The overall remission (OR) rate (Complete Remission [CR] + CR in the absence of total platelet recovery [CRp]) was evaluated. CR was defined as no evidence of circulating blasts or extramedullary disease, an M1 bone marrow ( ≤ 5% blasts), and recovery of peripheral counts [platelets ≥ 100 x 10 9/ L and absolute neutrophil count (ANC) ≥ x 10 9/ L]. CRp was defined as meeting all criteria for CR except for recovery of platelet counts to ≥ 100 x 10 9/ L. Partial Response (PR) was also determined, defined as complete disappearance of circulating blasts, an M2 bone marrow ( ≥ 5% and ≤ 25% blasts), and appearance of normal progenitor cells or an M1 marrow that did not qualify for CR or CRp. Duration of remission was also evaluated. Transplantation rate was not a study endpoint.

Atypical subtrochanteric and diaphyseal femoral fractures have been reported in patients receiving bisphosphonate therapy, including Zometa. These fractures can occur anywhere in the femoral shaft from just below the lesser trochanter to just above the supracondylar flare and are transverse or short oblique in orientation without evidence of comminution. These fractures occur after minimal or no trauma. Patients may experience thigh or groin pain weeks to months before presenting with a completed femoral fracture . Fractures are often bilateral ; therefore the contralateral femur should be examined in bisphosphonate-treated patients who have sustained a femoral shaft fracture. Poor healing of these fractures has also been reported. A number of case reports noted that patients were also receiving treatment with glucocorticoids (such as prednisone or dexamethasone) at the time of fracture. Causality with bisphosphonate therapy has not been established.

Perhaps a more popular theory is that the immunosuppressive effects of immunoglobulin therapy are mediated through IgG's Fc glycosylation. By binding to receptors on antigen presenting cells, IVIG can increase the expression of the inhibitory Fc receptor , FcgRIIB and shorten the half-life of auto-reactive antibodies. [20] [21] [22] The ability of immunoglobulin therapy to suppress pathogenic immune responses by this mechanism is dependent on the presence of a sialylated glycan at position CH2- of IgG. [20] Specifically, de-sialylated preparations of immunoglobulin lose their therapeutic activity and the anti-inflammatory effects of IVIG can be recapitulated by administration of recombinant sialylated IgG1 Fc. [20]

Because steroids are hormones, patients who use them for long periods of time must be carefully monitored. The most common side effects are: weight gain; thinning of the skin; upset stomach; muscle weakness in the thighs, shoulders, and neck; “masking” or hiding a fever; mood swings; insomnia; pneumonia; and increased blood sugar levels (especially in patients with diabetes). Steroids can also interact with some seizure medications, either raising or lowering the seizure medicine levels in the blood, which can affect their effectiveness. Your doctor can explain other side effects that may occur with steroid use.

Intravenous steroids for ulcerative colitis

intravenous steroids for ulcerative colitis

Because steroids are hormones, patients who use them for long periods of time must be carefully monitored. The most common side effects are: weight gain; thinning of the skin; upset stomach; muscle weakness in the thighs, shoulders, and neck; “masking” or hiding a fever; mood swings; insomnia; pneumonia; and increased blood sugar levels (especially in patients with diabetes). Steroids can also interact with some seizure medications, either raising or lowering the seizure medicine levels in the blood, which can affect their effectiveness. Your doctor can explain other side effects that may occur with steroid use.

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