Constructing the function of prednisone efficacy for the treatment of inflammatory bowel diseases based on a clinical model

Aim

To determine the effective doses of prednisone for induction of remission in patients with ulcerative colitis (UC) and Crohn's disease (CD) based on the “dose-effect” relationship.

Material and methods

The study included 86 patients aged from 18 to 65 years with moderate or severe active inflammatory bowel disease (61 – UC, 25 – CD). All patients were treated with prednisone at an initial daily dose of 30 to 60 mg with a subsequent tapering of dose. The clinical response to treatment was evaluated at 2 weeks and at the time of complete withdrawal of prednisone using the generally accepted criteria. The “dose-effect” relationship for prednisone was constructed with statistical transformation of the baseline clinical data and a quantitative expression of the actual doses and alternative responses into a graph of the effectiveness function. The mean value at each point was estimated based on the regression kernel scoring method.

Results

Using the “dose-effect” relationship we estimated the optimal clinically effective dose of prednisone that was 50.70±0.65 mg daily (95% confidence interval 49.41-51.98). The expected maximum effect at this dose was 82.21±8.23% (95% confidence interval 66.08-98.33).

Conclusion

In a clinical model, we established the optimal clinically effective dose of prednisone for induction of remission in patients with UC and CD.

Key words

Ulcerative colitis, Crohn's disease, systemic corticosteroids, prednisone, efficacy function.