The Historical Role and Contemporary Use of Corticosteroids in Inflammatory Bowel Disease.

Autor: Dorrington AM; Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Selinger CP; Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Parkes GC; Department of Gastroenterology, Royal London Hospital, Barts Health, London, UK., Smith M; Department of Gastroenterology, Brighton and Sussex University Hospitals, Brighton, UK., Pollok RC; Department of Gastroenterology, St George's University Hospitals NHS Foundation Trust, London, UK., Raine T; Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Jazyk: angličtina
Zdroj: Journal of Crohn's & colitis [J Crohns Colitis] 2020 Sep 16; Vol. 14 (9), pp. 1316-1329.
DOI: 10.1093/ecco-jcc/jjaa053
Abstrakt: 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 USA and Europe. Nevertheless, although 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 are 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 health care and patient-level factors associated with the risk of corticosteroid exposure, including identification of 'at-risk' populations.
(© The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze: MEDLINE
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