The historical role and contemporary use of corticosteroids in inflammatory bowel disease.

  title={The historical role and contemporary use of corticosteroids in inflammatory bowel disease.},
  author={Alexander M Dorrington and Christian Philipp Selinger and Gareth C Parkes and Melissa Smith and Richard C G Pollok and Tim Raine},
  journal={Journal of Crohn's \& colitis},
The use of corticosteroids to treat patients with inflammatory bowel disease (IBD) has been the bedrock of IBD therapeutics since the pioneering work of Truelove and Witts in the UK in the 1950s and subsequent large cohort studies in the US and Europe. Nevertheless, whilst effective for induction of remission, these agents do not maintain remission and are associated with a long list of recognised side effects, including a risk of increased mortality. With the arrival of an increasing number of… 

Tables from this paper

Common mistakes with steroids

  • Y. An
  • Medicine
    Journal of gastroenterology and hepatology
  • 2021
Physicians need to improve the use of currently available corticosteroids by personalizing it to the patient and their disease activity and to educate and engage patients and general practitioners regarding the proper role of cortiosteroids in IBD treatment.

Editorial: progress towards more comprehensively understanding the sources of corticosteroids for patients with inflammatory bowel disease—authors' reply

It is shown that poor access to the IBD service is associated with steroid excess and it is desirable, but currently unreal-istic, to expect that IBD units should mainly be prescribing steroids for IBD flares.

Inflammatory Bowel Disease Treatments and Predictive Biomarkers of Therapeutic Response

This review aims to offer a comprehensive overview of available treatment options and emerging therapeutic approaches for IBD patients and predictive biomarkers for monitoring the therapeutic response to different IBD therapies are discussed.

Steroid use and misuse: a key performance indicator in the management of IBD

Indications for corticosteroid use in IBD, their risks and strategies to reduce their use and misuse are outlined.

Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study

During the COVID-19 pandemic many IBD units chose Budesonide MMX (Cortiment) as the first-line treatment for flares of ulcerative colitis in outpatients for its favourable side effect profile, but Cortiment was associated with worse outcomes at four weeks.

Declining Corticosteroid Use for Inflammatory Bowel Disease Across Alberta: A Population-Based Cohort Study

An increase in anti-TNF use corresponded to a decline in corticosteroid use and dependence in those with IBD, and inequities in IBD care still exist based on location and age.

A review of the therapeutic management of Crohn’s disease

In this review, the key milestones in the medical management of Crohn’s disease are discussed and improved outcomes with reduction in surgery and ability to achieve clinical and endoscopic remission are discussed.

Older patients benefit more from sequential courses of washed microbiota transplantation than younger population with ulcerative colitis.

This study indicated WMT could induce short-term steroid-free clinical remission and maintain long-term response in UC, especially for older patients and patients undergoing sequential courses.

Treatment Effects of Natural Products on Inflammatory Bowel Disease In Vivo and Their Mechanisms: Based on Animal Experiments

The aim of this review is to provide a systematic and credible summary, thus supporting the research on NPs for the treatment of IBD and providing a theoretical basis for the development and application of NPs in drugs and functional foods.

Home Infliximab Infusions Are Associated With Suboptimal Outcomes Without Cost Savings in Inflammatory Bowel Diseases.

Comparing biologic medication use, health outcomes, and overall cost of care for adult and pediatric patients with IBD receiving home vs office- vs hospital-based infliximab infusions found home infusions were associated with suboptimal outcomes including higher rates of nonadherence and discontinuation of inflIXimab.



Prevalence of and Outcomes Associated with Corticosteroid Prescription in Inflammatory Bowel Disease

Heavy corticosteroid use in the first year after IBD diagnosis was associated with a 3 times increased hazard of resective surgery and Cumulative cortiosteroid exposure did not decrease among those diagnosed with IBD in more recent years, despite increasing use of immunomodulators.

Corticosteroid Use and Complications in a US Inflammatory Bowel Disease Cohort

Prolonged corticosteroid therapy for the treatment of IBD is common and is associated with significant harm to patients, and universal efforts to improve the delivery of high quality care should be undertaken.

Guidelines for the management of inflammatory bowel disease in adults

The present document is intended primarily for the use of clinicians in the United Kingdom, and serves to replace the previous BSG guidelines in IBD, while complementing recent consensus statements published by the European Crohn's and Colitis Organisation (ECCO).

Using corticosteroids appropriately in inflammatory bowel disease: a guide for primary care.

  • K. BarrettS. SaxenaR. Pollok
  • Medicine
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 2018
Patients with IBD flare-ups usually present with a combination of diarrhoea, abdominal pain, or rectal bleeding, although atypical presentations including weight loss, anaemia, and failure to thrive can occur, and the severity of symptoms may not reflect the severityof inflammation, particularly in children.

Traditional corticosteroids for induction of remission in Crohn's disease.

Although corticosteroids cause more adverse events than either placebo or low-dose 5-ASA, these adverse events did not lead to increased study withdrawal in the included studies, and Corticosteroid are effective for induction of remission in patients with CD, particularly when used for more than 15 weeks.

The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study.

At 1 year, 32% of patients with Crohn's disease and 48% with ulcerative colitis are corticosteroid free without operation.

Corticosteroid Sparing in Inflammatory Bowel Disease is More Often Achieved in the Immunomodulator and Biological Era—Results from the Dutch Population-Based IBDSL Cohort

In a real-world setting, more recently diagnosed IBD patients used lower amounts of corticosteroids as of the second year of disease, and a significant association was found with the use of immunomodulators and biologicals.

Treatment of ulcerative colitis with corticotropin (ACTH) and cortisone; a two year follow-up.

The purpose of this communication is to report the experiences with the use of corticotropin (ACTH) and cortisone in a selected group of patients with ulcerative colitis to determine the effectiveness of hormone therapy in inducing a remission in the disease.

Corticosteroids for maintenance of remission in Crohn's disease.

The use of conventional systemic corticosteroids in patients with clinically quiescent Crohn's disease does not appear to reduce the risk of relapse over a 24 month period of follow-up.

Corticosteroids in Crohn’s disease

Alternative classes of medical therapy for Crohn's disease, including modified corticosteroids and a group of new biological therapies, have proven to be efficacious in the management of active and/or quiescent Crohn't disease.