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Published on: March 12, 2020
Steroid use in Crohn's disease
Stephan R Vavricka1, Alain M Schoepfer, Michael Scharl
1Division of Gastroenterology and Hepatology, Stadtspital Triemli Hospital, Zurich, 8063, Switzerland, stephan.vavricka@triemli.zuerich.ch.
Corticosteroids effectively treat Crohn's disease relapses but have drawbacks. This review explores their use, focusing on minimizing side effects and dependency with strategies like budesonide.
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Crohn's disease incidence is rising globally, especially in Western countries and Asia.
- Corticosteroids are the primary treatment for moderate-to-severe Crohn's disease relapses.
- While effective, corticosteroids present significant drawbacks and potential for dependency.
Purpose of the Study:
- To review the role of corticosteroids in inducing remission for adult Crohn's disease patients.
- To discuss strategies for corticosteroid sparing and minimizing dependency.
- To evaluate newer agents like budesonide for reduced systemic adverse effects.
Main Methods:
- Comprehensive literature review of corticosteroid use in Crohn's disease.
- Analysis of clinical trial data and observational studies.
- Examination of pharmacologic profiles and adverse event data.
Main Results:
- Corticosteroids remain a cornerstone for inducing remission in active Crohn's disease.
- Corticosteroid-sparing strategies are crucial for long-term management.
- Budesonide demonstrates a favorable safety profile with reduced systemic effects.
Conclusions:
- Optimizing corticosteroid use is essential for managing Crohn's disease.
- Minimizing corticosteroid exposure and dependency is a key therapeutic goal.
- Budesonide offers a valuable option for treating Crohn's disease with fewer systemic side effects.
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