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Colchicine as an Alternative First-Line Treatment of Sclerosing Mesenteritis: A Retrospective Study.

Authors
  • Cortés, Pedro1
  • Ghoz, Hassan M2
  • Mzaik, Obaie2
  • Alhaj Moustafa, Muhamad3
  • Bi, Yan2
  • Brahmbhatt, Bhaumik2
  • Daoud, Nader2
  • Pang, Maoyin4
  • 1 Division of Medicine, Mayo Clinic Florida, Jacksonville, 32224, USA.
  • 2 Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
  • 3 Division of Hematology and Oncology, Mayo Clinic Florida, Jacksonville, 32224, USA.
  • 4 Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA. [email protected]
Type
Published Article
Journal
Digestive Diseases and Sciences
Publisher
Springer-Verlag
Publication Date
Jun 01, 2022
Volume
67
Issue
6
Pages
2403–2412
Identifiers
DOI: 10.1007/s10620-021-07081-4
PMID: 34086165
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Sclerosing mesenteritis is a rare condition characterized by chronic inflammation and fibrotic changes of the mesentery. To determine the long-term management and outcomes of patients with sclerosing mesenteritis. Patients with biopsy-proven sclerosing mesenteritis at the Mayo Clinic between January 2006 and December 2016 were identified. Clinical data were collected retrospectively. One hundred and three patients were identified, median age 68.0 years (range 35.0-85.3). Most patients were symptomatic (87.4%) at presentation. Patients received no treatment (52.4%), medical therapy (42.7%) or surgery (4.9%) on initial diagnosis. The most common initial regimens were prednisone plus tamoxifen (41.9%), prednisone alone (23.3%), and prednisone plus colchicine (11.6%) with 55.6%, 57.2%, and 60% of patients improving, respectively, p = 0.85 for a difference in response rates. At least half of the patients responded to prednisone plus tamoxifen, prednisone plus colchicine, or prednisone alone at 6.0, 7.2, and 8.4 months, respectively. At a median follow-up of 45.6 months (95% CI 24.1-69.7), 65.4% of patients were receiving medical therapy. Of those receiving tamoxifen-based, steroid-based, or steroid-sparing regimens, 100%, 87.5%, and 77.8% had improved by their last follow-up appointment respectively, p = 0.15. Prednisone plus colchicine has a similar efficacy to prednisone plus tamoxifen for the initial and long-term treatment of sclerosing mesenteritis. The majority of patients were initiated on medical therapy over the long term with most reporting symptomatic improvement within a year. Death from SM was rare. © 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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