While systemic corticosteroids (e.g., prednisone) are effective in inducing symptomatic remission in IBD, they are ineffective as maintenance therapy and are associated with both short- and long-term serious adverse effects. Consequently, if the initial steroid taper is unsuccessful or more than two courses of steroids are required within a year, health providers should consider adding a steroid-sparing agent that has proven efficacy and safety as maintenance therapy in IBD patients.

Conditions: Inflammatory bowel disease (IBD)

Treatments: Steroids, prednisone, steroid-sparing agent

Sources

• Bressler B, et al. Clinical practice guidelines for the medical management of nonhospitalized ulcerative colitis: the Toronto consensus. Gastroenterology. 2015 May;148(5):1035-1058.e3. (PubMed)
• Gomollón F, et al. 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management. J Crohns Colitis. 2017 Jan;11(1):3-25. (PubMed)
• Harbord M, et al. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 2: Current Management. J Crohns Colitis. 2017, 1–24.
• Terdiman JP, et al. American Gastroenterological Association Institute guideline on the use of thiopurines, methotrexate, and anti-TNF-α biologic drugs for the induction and maintenance of remission in inflammatory Crohn's disease. Gastroenterology. 2013 Dec;145(6):1459-63. (PubMed)