Corticosteroids remain a highly efficient mainstay in the management of irritable bowel disease. Presentations held in an enlightening symposium entitled “The Illusion of Remission,” presented at the 15th congress of the European Crohn’s and Colitis Organisation (ECCO) in Vienna, Austria, included discussions on the uses of corticosteroids, particularly to treat moderate-to-severe ulcerative colitis, and the benefits of increased monitoring of this therapy. Dr Tim Raine acknowledged the guidelines recommending the use of corticosteroid-sparing therapies, the widely continued use of corticosteroids for IBD despite this, and how monitoring steroid use in clinics at regular timepoints can provide a quality measure for an IBD unit. Prof Iris Dotan highlighted that corticosteroid prescribing behaviours in clinics do not consistently match the guidelines and their use may be underestimated depending on the type of setting in which the therapy is given. Prof Dotan also suggested that there may be an opportunity for collaborative work with physicians and in primary care to reduce excessive use. Dr Mark Silverberg finished with a summary of the evolution of irritable bowel disease clinical trial design, stating that original studies had no corticosteroid-tapering protocols, and new trials must establish this in advance to achieve steroid-free remission and to provide clarity on data outcomes.
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