Editorial | Published:

Inflammatory Bowel Disease

Past Time for Doctors to Lessen their Dependence on Corticosteroids in the Treatment of IBD

The American Journal of Gastroenterology volume 113, pages 418420 (2018) | Download Citation



Corticosteroids and antibodies to tumor necrosis factor (anti-TNF) are mainstays of treatment of acutely active IBD and while anti-TNF therapy is indicated for maintenance therapy, chronic corticosteroid therapy is associated with known significant risks. Nonetheless, chronic or recurrent corticosteroid treatment in IBD is common. In this edition of the journal Lewis et al. use Medicaid and Medicare databases to contrast adverse outcomes in persons with IBD and either corticosteroid or anti-TNF use. Compared to high dose corticosteroid use, anti TNF therapy is associated with less risk for death in Crohn’s disease but no statistical difference in death outcomes in ulcerative colitis. The adverse effects of corticosteroids are well known yet vigilance is still required to ensure their use is limited to the short term.

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Author information


  1. Department of Internal Medicine, University of Manitoba IBD Clinical and Research Centre and Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

    • Charles N Bernstein


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Competing interests

Guarantor of the article: Charles Bernstein, MD.

Specific author contributions: Dr Bernstein conceived, wrote and edited the manuscript.

Financial support: None.

Potential competing interests: Charles Bernstein has consulted to Abbvie Canada, Ferring Canada, Janssen Canada, Pfizer Canada, Shire Canada, Takeda Canada, and Napo Pharmaceuticals and has consulted to Mylan Pharmaceuticals. He has received unrestricted educational grants from Abbvie Canada, Janssen Canada, Shire Canada, and Takeda Canada. He has been on speaker’s bureau of Abbvie Canada, Ferring Canada and Shire Canada.

Corresponding author

Correspondence to Charles N Bernstein.

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