Corticosteroids in ulcerative colitis: a skeptical view

Corticosteroids have numerous antiinflammatory actions and have been used in the treatment of ulcerative colitis since 1950. One can expect a remission rate of 60-80% in patients with moderately severe ulcerative colitis and of 40-55% in severe ulcerative colitis. However, this success often is not sustained. There is no universal agreement on the dose, route of administration, or type of corticosteroid used in published treatment regimens. In this editorial, I discuss these matters.