Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

David T Rubin, MD; Sonia Friedman, MD; Francis A Farraye, MD MSc

Question 14: Which Therapies Are Steroid Sparing In Crohn’S Disease And Ulcerative Colitis? How Should I Manage A Steroid Dependent Patient? (continued)

David Kotlyar, MD; Wojciech Blonski, MD; Joseph Gorodenker, MD; Gary R. Lichtenstein, MD

Therapy with corticosteroids (CS) has remained a crucial bulwark of treatment for patients with inflammatory bowel disease (IBD) since the initial studies on the topic published in 1955.1 Unfortunately, some patients will either not respond to or become dependent on CS, with immediate symptomatic recurrence if their CS therapy is stopped or their dosage lowered. The definition of CS dependence has varied; however, a recent well-accepted definition is a relapse of inflammatory bowel disease (IBD)-related symptoms either within 30 days after cessation of CS or during CS-dose reduction…