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.
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).
In a clinical model, we established the optimal clinically effective dose of prednisone for induction of remission in patients with UC and CD.
Ulcerative colitis, Crohn's disease, systemic corticosteroids, prednisone, efficacy function.