P507 Evolution of osteopenia and osteoporosis over 5 years in patients with inflammatory bowel disease

Abstract

a first course of endovenous corticosteroids ECT in our tertiary center. Methods: All UC patients admitted to the hospital for an acute flare requiring EC between January 2007 and March 2012 were reviewed. We included only the patients with a first-initial course EC since UC diagnosis time. We defined as “responders” when patients achieved clinical remission in the first seven days of EC and “no responders” when patients needed a rescue therapy because of no clinical response after 7 days of EC. Demographic and clinical features were obtained from the medical records until October 2012. Results: A total of 41 episodes were collected during this period and 14 (34%) completed inclusion criteria. EC “response” was obtained in 9 patients (9/14; 60%, 5F/4M, mean age 36 years). Half of them (5/9), the diagnosis of UC concurred with the hospitalization and EC therapy. After a median follow-up of 24 months (6 56), 4 patients (44%) needed treatment escalation by using IMM for steroid-dependency and 2 (22%) of them used granulocyte aphaeresis before a-TNF therapy. No surgeries were observed in this group. Five patients were EC “no responders” (5/14; 40%, 4F/1M, mean age 30 years). A-TNF therapy was used in 1 patient and 4 received Cyclosporine A (CyA) for steroid-refractoriness and 3 were newly UC diagnose. One patient underwent total colectomy 10 days after EC beginning without further complication or treatment. After 36 months (5 63), 4 patients started IMM (80%) and 1 started a-TNF (20%) but developed a tuberculosis (TBC) infection and after TBC treatment remained with only IMM therapy. Nowadays, 2 more patients (40%) were considered for a-TNF because steroiddependency after acute flare (mean time 6 months). No other surgeries were produced during follow-up. Conclusions: In our center, about half of patients developed a “no responder” to EC flare and most of them will need a-TNF for maintenance therapy even after use of CyA treatment mainly because of steroid-dependence. Even when the UC patients respond to EC, about 40% of them require IMM and even a-TNF for again for steroid-dependence.