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

Dorrington, AM; Selinger, CP; Parkes, GC; Smith, M; Pollok, RC; Raine, T (2020) The historical role and contemporary use of corticosteroids in inflammatory bowel disease. J Crohns Colitis. ISSN 1876-4479 https://doi.org/10.1093/ecco-jcc/jjaa053

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Abstract

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 therapies for patients with IBD, the question arises as to whether we are using these agents appropriately in contemporary practice. This review discusses the historical background to steroid usage in IBD, and also provides a brief review of the literature on side effects of corticosteroid treatment as relevant to IBD patients. Data on licensed medications is presented with specific reference to the achievement of corticosteroid-free remission. We review available international data on the incidence of corticosteroid exposure and excess and discuss some of the observations we and others have made concerning healthcare and patient-level factors associated with the risk of corticosteroid exposure, including identification of 'at-risk' populations.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Crohn's and Colitis following peer review. The version of record Alexander M Dorrington, Christian P Selinger, Gareth C Parkes, Melissa Smith, Richard C Pollok, Tim Raine, The historical role and contemporary use of corticosteroids in inflammatory bowel disease, Journal of Crohn's and Colitis, , jjaa053 is available online at: https://doi.org/10.1093/ecco-jcc/jjaa053
Keywords: Gastroenterology & Hepatology, 1103 Clinical Sciences
Journal or Publication Title: J Crohns Colitis
ISSN: 1876-4479
Language: eng
Dates:
DateEvent
14 March 2020Published Online
Publisher License: Publisher's own licence
PubMed ID: 32170314
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111801
Publisher's version: https://doi.org/10.1093/ecco-jcc/jjaa053

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