Gibson DJ, et al. - Given that identifying hospitalized patients with acute severe ulcerative colitis (ASUC) who will be refractory to corticosteroid therapy and require rescue therapy remains difficult, the researchers determined the optimal stool frequency, C-reactive protein (CRP), albumin, and CRP/albumin ratio (CAR) to predict steroid response. From January 2010 to December 2014, patients with histologically confirmed ulcerative colitis admitted with ASUC over a 5-year period were identified. The study results showed that raised D3 CAR was an early predictor of steroid-refractory ASUC. Its predictive ability improves when combined with D3 stool frequency. Findings suggested that early introduction of rescue infliximab (IFX) at this stage could be more useful before serum albumin falls profoundly in patients with predicted steroid nonresponse.