Header

UZH-Logo

Maintenance Infos

Therapy of steroid-resistant inflammatory bowel disease


Manz, Michael; Vavricka, Stephan R; Wanner, Roger; Lakatos, Peter L; Rogler, Gerhard; Frei, Pascal; Safroneeva, Ekaterina; Schoepfer, Alain M (2012). Therapy of steroid-resistant inflammatory bowel disease. Digestion, 86(Suppl. 1):11-15.

Abstract

BACKGROUND AND AIMS: Although systemic corticosteroids are successfully administered for the induction of clinical response and remission in the majority of patients with inflammatory bowel disease (IBD) presenting with a flare, a proportion of these patients demonstrate a primary nonresponse to steroids or in the case of an initial response, they develop a resistance or a steroid dependence. Long-term therapy with corticosteroids for treatment of IBD should be avoided, given the high frequency of adverse treatment effects. Knowledge about treatment strategies in case of steroid nonresponse is therefore highly relevant.
METHODS: A systematic literature research was performed using Medline and Embase to summarize the currently recommended treatment strategies for steroid-resistant IBD.
RESULTS: Treatment of steroid-resistant Crohn's disease is based on the introduction of immunomodulators such as azathioprine, 6-mercaptopurine or methotrexate, the anti-TNF drugs infliximab, adalimumab and certolizumab pegol. In the case of steroid resistance in ulcerative colitis, aminosalicylates, the above-mentioned immunomodulators, infliximab, adalimumab or calcineurin inhibitors such as ciclosporin or tacrolimus may be administered.
CONCLUSION: This review summarizes the current evidence for treating steroid-resistant IBD.

Abstract

BACKGROUND AND AIMS: Although systemic corticosteroids are successfully administered for the induction of clinical response and remission in the majority of patients with inflammatory bowel disease (IBD) presenting with a flare, a proportion of these patients demonstrate a primary nonresponse to steroids or in the case of an initial response, they develop a resistance or a steroid dependence. Long-term therapy with corticosteroids for treatment of IBD should be avoided, given the high frequency of adverse treatment effects. Knowledge about treatment strategies in case of steroid nonresponse is therefore highly relevant.
METHODS: A systematic literature research was performed using Medline and Embase to summarize the currently recommended treatment strategies for steroid-resistant IBD.
RESULTS: Treatment of steroid-resistant Crohn's disease is based on the introduction of immunomodulators such as azathioprine, 6-mercaptopurine or methotrexate, the anti-TNF drugs infliximab, adalimumab and certolizumab pegol. In the case of steroid resistance in ulcerative colitis, aminosalicylates, the above-mentioned immunomodulators, infliximab, adalimumab or calcineurin inhibitors such as ciclosporin or tacrolimus may be administered.
CONCLUSION: This review summarizes the current evidence for treating steroid-resistant IBD.

Statistics

Citations

11 citations in Web of Science®
13 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

261 downloads since deposited on 13 Mar 2013
92 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gastroenterology and Hepatology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:13 Mar 2013 14:03
Last Modified:07 Dec 2017 20:35
Publisher:Karger
ISSN:0012-2823
Publisher DOI:https://doi.org/10.1159/000341952
PubMed ID:23051721

Download

Download PDF  'Therapy of steroid-resistant inflammatory bowel disease'.
Preview
Content: Accepted Version
Filetype: PDF
Size: 96kB
View at publisher
Download PDF  'Therapy of steroid-resistant inflammatory bowel disease'.
Preview
Content: Published Version
Filetype: PDF
Size: 107kB
Filetype: Other (Coversheet Pages conversion from application/pdf to application/pdf)