Therapy of steroid-resistant inflammatory bowel disease

Michael Manz, Stephan R. Vavricka, Roger Wanner, Peter L. Lakatos, Gerhard Rogler, Pascal Frei, Ekaterina Safroneeva, Alain M. Schoepfer

Research output: Contribution to journalArticle

19 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)11-15
Number of pages5
JournalDigestion
Volume86
Issue numberSUPPL. 1
DOIs
Publication statusPublished - Oct 1 2012

Keywords

  • Crohn's disease
  • Steroid-resistant inflammatory bowel disease
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

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  • Cite this

    Manz, M., Vavricka, S. R., Wanner, R., Lakatos, P. L., Rogler, G., Frei, P., Safroneeva, E., & Schoepfer, A. M. (2012). Therapy of steroid-resistant inflammatory bowel disease. Digestion, 86(SUPPL. 1), 11-15. https://doi.org/10.1159/000341952