[Assessment of corticosteroid use as a marker of quality-of-care in the management of inflammatory bowel disease]

Rev Gastroenterol Peru. 2024 Oct-Dec;44(4):339-345.
[Article in Spanish]

Abstract

Introduction: Despite advancements in therapeutic strategies, corticosteroids continue to play a role in inducing remission in Inflammatory Bowel Disease (IBD). Unfortunately, these drugs are often misused.

Objectives: To assess the dose and duration of corticosteroid therapy,and the subsequent change in treatment among patients with IBD.

Materials and methods: We conducted a descriptive, retrospective observational study on patients with IBD under follow-up at the IBD Program of Clínica Universidad de los Andes from January 2021 to August2022.

Results: Four hundred and thirty-two IBD were included, with 63% being women,with a median age of 42 years (14-94), 66% had ulcerative colitis (UC). Sixty-six percentageof patients had received corticosteroids during the course of their disease (range 1-9 times) for a median duration of 12 weeks (2-48 weeks), with prednisone being the most frequently used corticosteroids (53%). Seventy-seven percentage of patients had received treatment for over 3 months or in supratherapeutic doses (prednisone > 60 mg day). There was a change in the treatment after the use of corticosteroid in 28% of patients compared to 90% after entering the program (p<0.001, CI95%: 1.83-2.49). During the Program's follow-up, 10% received corticosteroids (71% prednisone, 29% budesonide) with no variations based on IBD type, gender, age, or treatment. No patient received corticosteroids for over 3 months or in supratherapeutic doses in our IBD Program.

Conclusion: This study emphasizes the importanceof evaluating corticosteroids use as a quality-of -care marker in IBD. The management of these patients through a specialized program could mitigate the excessive use of these drugs.

Publication types

  • Observational Study
  • English Abstract

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Colitis, Ulcerative / drug therapy
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Glucocorticoids