Abstract
Background
Sclerosing mesenteritis is a rare condition characterized by chronic inflammation and fibrotic changes of the mesentery.
Aims
To determine the long-term management and outcomes of patients with sclerosing mesenteritis.
Methods
Patients with biopsy-proven sclerosing mesenteritis at the Mayo Clinic between January 2006 and December 2016 were identified. Clinical data were collected retrospectively.
Results
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.
Conclusion
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.
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PC was involved in data collection, statistical analyses, manuscript drafting and editing. HMG helped in conceptualization, data collection, and manuscript review. OM contributed to data collection. MAM was involved in manuscript review. YB helped in conceptualization and manuscript review. BB contributed to conceptualization and manuscript review. ND was involved in data collection. MP helped in study supervision conceptualization and manuscript review.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this retrospective study, formal consent is not required.
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Cortés, P., Ghoz, H.M., Mzaik, O. et al. Colchicine as an Alternative First-Line Treatment of Sclerosing Mesenteritis: A Retrospective Study. Dig Dis Sci 67, 2403–2412 (2022). https://doi.org/10.1007/s10620-021-07081-4
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DOI: https://doi.org/10.1007/s10620-021-07081-4