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How to do without steroids in inflammatory bowel disease
1Mount Sinai Medical Center, New York, USA.
Inflammatory Bowel Diseases
|March 4, 2000
Summary
This review examines steroid use for ulcerative colitis and Crohn's disease, finding they induce remission but don't maintain it and cause toxicity. Alternatives for inflammatory bowel disease management are discussed.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pharmacology
Background:
- Steroids are commonly used for inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD).
- Their efficacy in inducing remission is established, but long-term benefits and risks require careful consideration.
- Toxicity associated with prolonged steroid use is a significant concern in IBD management.
Purpose of the Study:
- To review the role of steroids in inducing and maintaining remission for UC and CD.
- To highlight the toxicity risks associated with long-term steroid therapy.
- To present alternative treatment strategies for IBD.
Main Methods:
- Comprehensive review of controlled and uncontrolled clinical trials on steroid use in IBD.
- Analysis of data regarding steroid efficacy, toxicity, and remission maintenance.
- Exploration of alternative therapies including antibiotics, immunosuppressives, and combination treatments.
Main Results:
- Steroids effectively induce remission in both UC and CD.
- Controlled trials demonstrate that steroids do not maintain remission in either disorder.
- Prolonged steroid use is associated with a high incidence of toxicity.
Conclusions:
- While steroids can initiate remission, they are not suitable for long-term maintenance therapy in IBD.
- Alternative treatments should be considered for mild to moderate active UC and CD.
- A shift towards non-steroidal or combination therapies is recommended for sustained IBD management.