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

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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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Funding

The authors did not receive funding.

Author information

Authors and Affiliations

  1. Division of Medicine, Mayo Clinic Florida, Jacksonville, 32224, USA

    Pedro Cortés

  2. Division of Gastroenterology and Hepatology, Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA

    Hassan M. Ghoz, Obaie Mzaik, Yan Bi, Bhaumik Brahmbhatt, Nader Daoud & Maoyin Pang

  3. Division of Hematology and Oncology, Mayo Clinic Florida, Jacksonville, 32224, USA

    Muhamad Alhaj Moustafa

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  1. Pedro Cortés
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Contributions

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.

Corresponding author

Correspondence to Maoyin Pang.

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The authors declare that they have no conflict of interest.

Ethics approval

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

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