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主論⽂
Figure legends
Figure 1. Study flow chart and numbers of patients.
Figure 2. Proportion of patients with clinical remission at day 30 according to age of
onset, grouped by every 10 years of age.
Figure 3. Kaplan-Meier plots of colectomy rate.
主論⽂
Table 1. Baseline characteristics of the study participants
Younger-onset UC (n=384)
Older-onset UC (n=83)
Male (n, %)
234 (60.9)
50 (60.2)
Body weight (mean in kg, SD)
58.0 (12.6)
56.1 (10.6)
Age of onset (median in years, IQR)
32 (22–44)
68 (63–72)
Disease duration (median in months, IQR)
18 (1–80.5)
2 (0–28)
0 ≤ duration < 1 month (n, %)
54 (14.1)
26 (31.3)
1 ≤ duration < 12 months (n, %)
117 (30.5)
31 (37.4)
12 months ≤ duration (n, %)
213 (55.5)
26 (31.3)
Proctitis (n, %)
3 (0.8)
0 (0)
Left-sided colitis (n, %)
65 (16.9)
20 (24.1)
Extensive colitis (n, %)
316 (82.3)
63 (75.9)
Moderately severe (n, %)
218 (56.8)
46 (55.4)
Acute severe (n, %)
166 (43.2)
37 (44.6)
5 (4–6)
5 (3–6)
Stool frequency subscore (median, IQR)
3 (3–3)
3 (2–3)
Rectal bleeding subscore (median, IQR)
2 (1–3)
2 (1–3)
5-aminosalicylic acid (n, %)
314 (81.8)
64 (77.1)
Immunomodulators (n, %)
28 (7.3)
1 (1.2)
NSAIDs (n, %)
20 (5.2)
5 (6.0)
Anticoagulant drugs (n, %)
5 (1.3)
3 (3.6)
Antiplatelet drugs (n, %)
6 (1.6)
5 (6.0)
History of oral steroid use (n, %)
139 (36.4)
17 (20.7)
History of biologic use (n, %)
8 (2.1)
3 (3.6)
Charlson comorbidity index ≥ 1 (n, %)
37 (9.6)
35 (42.2)
Current smoker (n, %)
92 (25.3)
32 (40.0)
CRP (median in mg/L, IQR)
63 (21–125)
71 (28–121)
Initial dose of steroid (mean in mg, SD)
54.1 (11.1)
51.7 (10.7)
University hospital (n, %)
313 (81.5)
64 (77.1)
Disease extent
Disease severity (Truelove and Witts criteria)
PRO2 total score (median, IQR)
Concomitant drugs
UC denotes ulcerative colitis; IQR, interquartile range; SD, standard deviation; PRO2, two-item patient-reported outcome; NSAIDs,
non-steroidal anti-inflammatory drugs; CRP, C-reactive protein.
Missing data on current smoker in 23 (4.9%) participants, history of oral steroids use in 3 (0.6%) participants, and CRP in 2 (0.4%)
主論⽂
participants, and body weight in 4 (0.9%) participants.
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Table 2. Summary of primary and secondary outcomes of younger-onset UC and olderonset UC
Younger-onset UC
Older-onset UC
(n=384)
(n=83)
Crude RR (95% CI)
Adjusted† RR (95% CI)
Primary outcome
Clinical remission at day 30 (n, %)
252 (65.6)
43 (51.8)
0.79 (0.63–0.98)
0.74 (0.59–0.93)
Clinical remission at day 3 (n, %)
59 (15.4)
9 (10.8)
0.71 (0.36–1.37)
0.64 (0.32–1.28)
Clinical remission at day 7 (n, %)
141 (36.7)
22 (26.5)
0.72 (0.49–1.06)
0.69 (0.47–1.02)
Clinical remission at day 90 (n, %)
243 (63.3)
44 (53.0)
0.84 (0.67–1.04)
0.81 (0.64–1.01)
Steroid-free remission at day 90 (n, %)
128 (33.3)
29 (34.9)
1.05 (0.76–1.45)
1.07 (0.76–1.50)
Required surgery within 90 days (n, %)
12 (3.1)
17 (20.5)
6.55 (3.25–13.21)
8.92 (4.13–19.27)
Adverse events within 90 days (n, %)
35 (9.1)
21 (25.3)
2.78 (1.71–4.52)
2.19 (1.22–3.92)
Death‡ (n, %)
0 (0)
4 (4.8)
Infection (n, %)
33 (8.6)
15 (18.1)
Venous thrombosis (n, %)
2 (0.5)
6 (7.2)
Secondary outcomes
UC denotes ulcerative colitis; RR, risk ratio; CI, confidence interval.
†Adjusted for sex, disease duration, disease extent, disease severity, comorbidity, use of concomitant drugs (5-aminosalicylic acid,
immunomodulators, non-steroidal anti-inflammatory drugs, anticoagulant drugs, and antiplatelet drugs), and smoking status.
‡ The causes of death: pneumocystis pneumonia, bacterial pneumonia, stroke, and multiple organ failure due to uncontrolled UC.
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Table 3. Baseline characteristics of young UC, older individuals with younger-onset UC,
and older individuals with older-onset UC
Young (< 60 years)
Older individuals (≥ 60 years)
Younger-onset UC
Younger-onset UC
Older-onset UC
(n=351)
(n=33)
(n=83)
Male (n, %)
216 (61.5)
18 (54.6)
50 (60.2)
Body weight (mean in kg, SD)
58.4 (12.7)
54.7 (10.8)
56.1 (10.6)
Age of onset (median in years, IQR)
30 (21–42)
52 (47–58)
68 (63–72)
Disease duration (median in months, IQR)
13 (1–65)
150 (48–259)
2 (0–28)
0 ≤ duration < 1 month (n, %)
54 (15.4)
0 (0)
26 (31.3)
1 ≤ duration < 12 months (n, %)
114 (32.5)
3 (9.1)
31 (37.4)
12 months ≤ duration (n, %)
183 (52.1)
30 (90.9)
26 (31.3)
Proctitis (n, %)
3 (0.9)
0 (0)
0 (0)
Left-sided colitis (n, %)
55 (15.7)
10 (30.3)
20 (24.1)
Extensive colitis (n, %)
293 (83.5)
23 (69.7)
63 (75.9)
Moderately severe (n, %)
195 (55.6)
23 (69.7)
46 (55.4)
Acute severe (n, %)
156 (44.4)
10 (30.3)
37 (44.6)
5 (4–6)
5 (4–5)
5 (3–6)
Stool frequency subscore (median, IQR)
3 (3–3)
3 (3–3)
3 (2–3)
Rectal bleeding subscore (median, IQR)
2 (2–3)
2 (1–3)
2 (1–3)
5-aminosalicylic acid (n, %)
286 (81.5)
28 (84.9)
64 (77.1)
Immunomodulators (n, %)
27 (7.7)
1 (3.0)
1 (1.2)
NSAIDs (n, %)
17 (4.8)
3 (9.1)
5 (6.0)
Anticoagulant drugs (n, %)
3 (0.9)
2 (6.1)
3 (3.6)
Antiplatelet drugs (n, %)
6 (1.7)
0 (0)
5 (6.0)
History of oral steroid use (n, %)
122 (35.0)
17 (51.5)
17 (20.7)
History of biologic use (n, %)
8 (2.3)
0 (0)
3 (3.6)
Charlson comorbidity index ≥ 1 (n, %)
27 (7.7)
10 (30.3)
35 (42.2)
Current smoker (n, %)
86 (25.8)
6 (20.0)
32 (40.0)
CRP (median in mg/L, IQR)
65 (21–125)
61 (22–130)
71 (28–121)
Initial dose of steroid (mean in mg, SD)
54.4 (11.2)
51.2 (9.6)
51.7 (10.7)
Disease extent
Disease severity (Truelove and Witts criteria)
PRO2 total score (median, IQR)
Concomitant drugs
主論⽂
University hospital (n, %)
290 (82.6)
23 (69.7)
64 (77.1)
UC denotes ulcerative colitis; IQR, interquartile range; SD, standard deviation; PRO2, two-item patient-reported outcome; NSAIDs,
non-steroidal anti-inflammatory drugs; CRP, C-reactive protein.
Young UC was defined as age at initiation of intravenous steroids < 60 years and age of disease onset < 60 years.
Older individuals with younger-onset UC was defined as age at initiation of intravenous steroids ≥ 60 years and age of disease onset
< 60 years.
Older individuals with older-onset UC was defined as age at initiation of intravenous steroids ≥ 60 years and age of disease onset ≥
60 years.
Missing data on current smoker in 23 (4.9%) participants, history of oral steroids use in 3 (0.6%) participants, and CRP in 2 (0.4%)
participants, and body weight in 4 (0.9%) participants.
主論⽂
Table 4. Differences in clinical outcomes among young UC, older individuals with
younger-onset UC, and older individuals with older-onset UC
Young (< 60 years)
Older individuals (≥ 60 years)
Younger-onset UC
Younger-onset UC
Older-onset UC
(n=351)
(n=33)
(n=83)
Primary outcome
Clinical remission at day 30
Number of events (n, %)
230 (65.5)
22 (66.7)
43 (51.8)
Risk ratio (adjusted†, 95% CI)
1 [Reference]
0.91 (0.68–1.23)
0.73 (0.58–0.92)
Number of events (n, %)
52 (14.8)
7 (21.2)
9 (10.8)
Risk ratio (adjusted†, 95% CI)
1 [Reference]
0.97 (0.42–2.20)
0.64 (0.32–1.27)
Number of events (n, %)
126 (35.9)
15 (45.5)
22 (26.5)
Risk ratio (adjusted†, 95% CI)
1 [Reference]
1.14 (0.72–1.81)
0.70 (0.48–1.04)
Number of events (n, %)
224 (63.8)
19 (57.6)
44 (53.0)
Risk ratio (adjusted†, 95% CI)
1 [Reference]
0.73 (0.52–1.02)
0.78 (0.62–0.99)
Number of events (n, %)
120 (34.2)
8 (24.2)
29 (34.9)
Risk ratio (adjusted†, 95% CI)
1 [Reference]
0.47 (0.23–0.94)
1.01 (0.71–1.42)
Number of events (n, %)
11 (3.1)
1 (3.0)
17 (20.5)
Risk ratio (adjusted†, 95% CI)
1 [Reference]
1.93 (0.25–14.95)
9.25 (4.24–20.19)
30 (8.6)
5 (15.2)
21 (25.3)
Death (n, %)
0 (0)
0 (0)
4 (4.8)
Infection (n, %)
28 (8.0)
5 (15.2)
15 (18.1)
Venous thrombosis (n, %)
2 (0.6)
0 (0)
6 (7.2)
1 [Reference]
1.62 (0.68–3.88)
2.32 (1.29–4.18)
Secondary outcomes
Clinical remission at day 3
Clinical remission at day 7
Clinical remission at day 90
Steroid-free remission at day 90
Required surgery within 90 days
Adverse events within 90 days
Number of events (n, %)
Risk ratio (adjusted†, 95% CI)
UC denotes ulcerative colitis; CI, confidence interval.
†Adjusted for sex, disease duration, disease extent, disease severity, comorbidity, use of concomitant drugs (5-aminosalicylic acid,
immunomodulators, non-steroidal anti-inflammatory drugs, anticoagulant drugs, and antiplatelet drugs), and smoking status.
主論⽂
Appendix 1.
IBD Terakoya Group Collaborators
Shinji Okabayashi, Department of Healthcare Epidemiology, School of Public Health in
the Graduate School of Medicine, Kyoto University, Kyoto, Japan; Hajime Yamazaki,
Section of Clinical Epidemiology, Department of Community Medicine, Graduate School
of Medicine, Kyoto University, Kyoto, Japan; Keiichi Tominaga, Department of
Gastroenterology, Dokkyo Medical University, Tochigi, Japan; Miki Miura, Department of
Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan;
Shintaro Sagami, Center for Advanced IBD Research and Treatment, Kitasato University
Kitasato Institute Hospital, Tokyo, Japan; Katsuyoshi Matsuoka, Division of
Gastroenterology and Hepatology, Department of Internal Medicine, Toho University
Sakura Medical Center, Chiba, Japan; Yoshiharu Yamaguchi, Department of
Gastroenterology, Aichi Medical University School of Medicine, Aichi, Japan; Toshihiro
Noake, Department of Surgery, Kurume Coloproctology Center, Fukuoka, Japan; Keiji
Ozeki, Department of Gastroenterology and Metabolism, Nagoya City University
Graduate School of Medical Sciences, Aichi, Japan; Ryosuke Miyazaki, Division of
Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University
School of Medicine, Tokyo, Japan; Toshiaki Kamano, Department of gastroenterology,
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Fujita Health University, Aichi, Japan; Tomohiro Fukuda, Division of Gastroenterology
and Hepatology, Department of Internal Medicine, Keio University School of Medicine,
Tokyo, Japan; Kyoko Yoshioka, Department of Gastroenterology, Kure Kyosai Hospital,
Hiroshima, Japan; Katsuyoshi Ando, Gastroenterology and Endoscopy, Division of
Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology,
Asahikawa Medical University, Hokkaido, Japan; Masakatsu Fukuzawa, Department of
Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan; Sakuma
Takahashi, Department of Gastroenterology, Kagawa Prefectural Central Hospital,
Kagawa, Japan; Junnosuke Hayasaka, Department of Gastroenterology, Toranomon
Hospital, Tokyo, Japan; Kaoru Yokoyama, Department of Gastroenterology, Kitasato
University School of Medicine, Kanagawa, Japan; Kento Takenaka, Department of
Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan;
Yoichi Saegusa, Gastroenterology Center, JCHO Sagamino Hospital, Kanagawa, Japan;
Tsuyoshi Ogashiwa, Department of Gastroenterology, Yokohama Minami Kyosai Hospital,
Kanagawa, Japan; Yusuke Honzawa, Department of Gastroenterology and Hepatology,
Graduate School of Medicine, Kyoto University, Kyoto, Japan; Mizuki Tani, Department
of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine,
Osaka, Japan; Sohachi Nanjo, Department of Gastroenterology and Hematology,
主論⽂
University of Toyama, Toyama, Japan; Sachiko Oouchi, Department of Medicine, Steel
Memorial Hirohata Hospital, Hyogo, Japan; Daisuke Hirayama, Department of
Gastroenterology and Hepatology, Sapporo Medical University School of Medicine,
Hokkaido, Japan; Tsunaki Sawada, Department of Endoscopy, Nagoya University Hospital,
Aichi, Japan; Yuji Negoro, Department of Oncological Medicine, Kochi Health Sciences
Center, Kochi, Japan; Kei Moriya, Department of Gastroenterology, Nara Medical
University, Nara, Japan; Akira Andoh, Division of Gastroenterology, Shiga University of
Medical Science, Shiga, Japan; Yosuke Yamamoto, Department of Healthcare
Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto
University, Kyoto, Japan; Toshifumi Hibi, Center for Advanced IBD Research and
Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan; Taku Kobayashi,
Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute
Hospital, Tokyo, Japan.
主論文
Figure 1
480 Patients with UC were identified as meeting the
eligibility criteria
13 Patients were excluded
9 Hospital transfers
4 Loss to follow-up due to personal reason
83 Older-onset UC
467 Patients with UC were included in analysis
384 Younger-onset UC
主論文
Figure 2
Proportion of clinical remission at day 30
(%)
100
80
60
40
20
(n=56)
0-10's
(n=111)
20's
(n=84)
30's
(n=74)
40's
(n=59)
50's
(n=50)
60's
(n=28)
70's
(n=5)
80's
Age of onset (years)
主論文
Figure 3
Number at risk
Younger-onset UC
Older-onset UC
Colectomy rate
1.00
0.75
0.50
0.25
0.00
30
Younger-onset UC
Older-onset UC
15
382
73
377
68
45
375
67
60
375
66
Time since intravenous steroids start (days)
Log-rank P < 0.001
384
83
372
64
75
372
63
90
...
論文の公開元へ
