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Are steroids for inflammatory bowel disease being overused?

A recent study investigated the use of steroids for inflammatory bowel disease. Researchers looked at how many patients developed a dependency on steroids or had steroid overuse.


What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) is an inflammatory disease of the digestive tract, which includes Crohn’s disease and ulcerative colitis. It is a chronic condition, typically needing lifelong treatment. Steroids for inflammatory bowel disease are commonly used to treat flare-ups. Overuse of steroids is known to be associated with poor outcomes and adverse effects.

How often were steroids used in excess? Was it avoidable?

In a study published in Alimentary Pharmacology & Therapeutics, researchers aimed to look at overuse of steroids for inflammatory bowel disease. They then looked at the possibility of assessing the use of steroids to improve quality of care. The study consisted of 2,385 patients at 19 different centers across the UK. Some of these centers were previously involved in a quality improvement program. Using a simple computer program, the researchers evaluated patient cases in-depth. The goal of this program was to reduce the overuse of steroids.

All patients had a confirmed diagnosis of IBD and had the disease for at least three months. Data were collected to determine if steroid dependency was developed or if steroids were overused in the past 12 months. Patients met these criteria if they were on steroids for more than three months, they had more than one course, or if their symptoms returned soon after treatment.

It was determined that 14.8% of patients met the criteria for overuse. Out of the patients that overused steroids, about half of these cases were avoidable. It was observed that these rates were lower at the centers that had the quality improvement program in place. One exception was patients with moderate/severe ulcerative colitis. It was also noted that the more severe the disease, the greater the overuse of steroids. The study did not look at age, sex, or duration of the disease.

Why is this important?

Knowledge about IBD continues to improve. However, standards of care are lacking when compared to other disease states. This study demonstrates that overuse of steroids can be easily measured in clinical practice using a simple computer program. This measurement may be useful in improving standards, quality, and outcomes for patients and services.


Written by Kayla Dillon, B.S.



Selinger, Christian P. et al. Assessment Of Steroid Use As A Key Performance Indicator In Inflammatory Bowel Disease-Analysis Of Data From 2385 UK Patients. Alimentary Pharmacology and Therapeutics. 2019 March 24;00:1-10. doi: 10.1111/apt.15497.

Are steroids used too much for patients with inflammatory bowel disease?. 9 Oct 2019.

Image by silviarita from Pixabay




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