Review article: The management of steroid dependency in ulcerative colitis

G. Bianchi Porro, A. Cassinotti, E. Ferrara, G. Maconi, S. Ardizzone

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: Approximately 20% of patients with ulcerative colitis have a chronic active disease often requiring several courses of systemic steroids in order to achieve remission, but followed by relapse of symptoms during steroid tapering or soon after their discontinuation. Although short term control of symptoms can be achieved with steroid treatment, this pattern of drug response, known as steroid-dependency, leads to important complications of the treatment, while a significant proportion of patients requires colectomy. Aim: To review the studies currently available specifically evaluating the management of steroid-dependent ulcerative colitis. Results: The clinical and biological mechanisms of steroid-dependency are not well understood compared with those determining steroid-refractoriness. Very few evidence-based data are available concerning the management of patients with steroid-dependent ulcerative colitis. The therapeutic role of aminosalicylates, thiopurines, methotrexate, infliximab, leukocyte apheresis and other drugs in the treatment of steroid-dependent ulcerative colitis are evaluated. Conclusions: Outcomes of studies in steroid-refractory patients may not be applicable to steroid-dependency. Trials are needed to define the correct approaches and new strategies to ameliorate the therapy of steroid-dependent ulcerative colitis.

Original languageEnglish
Pages (from-to)779-794
Number of pages16
JournalAlimentary Pharmacology and Therapeutics
Volume26
Issue number6
DOIs
Publication statusPublished - Sep 2007

Fingerprint

Ulcerative Colitis
Steroids
Therapeutics
Blood Component Removal
Colectomy
Methotrexate
Pharmaceutical Preparations
Leukocytes
Chronic Disease
Outcome Assessment (Health Care)
Recurrence

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Review article : The management of steroid dependency in ulcerative colitis. / Porro, G. Bianchi; Cassinotti, A.; Ferrara, E.; Maconi, G.; Ardizzone, S.

In: Alimentary Pharmacology and Therapeutics, Vol. 26, No. 6, 09.2007, p. 779-794.

Research output: Contribution to journalArticle

Porro, G. Bianchi ; Cassinotti, A. ; Ferrara, E. ; Maconi, G. ; Ardizzone, S. / Review article : The management of steroid dependency in ulcerative colitis. In: Alimentary Pharmacology and Therapeutics. 2007 ; Vol. 26, No. 6. pp. 779-794.
@article{eaa8597c163944689c666c6283804fdb,
title = "Review article: The management of steroid dependency in ulcerative colitis",
abstract = "Background: Approximately 20{\%} of patients with ulcerative colitis have a chronic active disease often requiring several courses of systemic steroids in order to achieve remission, but followed by relapse of symptoms during steroid tapering or soon after their discontinuation. Although short term control of symptoms can be achieved with steroid treatment, this pattern of drug response, known as steroid-dependency, leads to important complications of the treatment, while a significant proportion of patients requires colectomy. Aim: To review the studies currently available specifically evaluating the management of steroid-dependent ulcerative colitis. Results: The clinical and biological mechanisms of steroid-dependency are not well understood compared with those determining steroid-refractoriness. Very few evidence-based data are available concerning the management of patients with steroid-dependent ulcerative colitis. The therapeutic role of aminosalicylates, thiopurines, methotrexate, infliximab, leukocyte apheresis and other drugs in the treatment of steroid-dependent ulcerative colitis are evaluated. Conclusions: Outcomes of studies in steroid-refractory patients may not be applicable to steroid-dependency. Trials are needed to define the correct approaches and new strategies to ameliorate the therapy of steroid-dependent ulcerative colitis.",
author = "Porro, {G. Bianchi} and A. Cassinotti and E. Ferrara and G. Maconi and S. Ardizzone",
year = "2007",
month = "9",
doi = "10.1111/j.1365-2036.2007.03334.x",
language = "English",
volume = "26",
pages = "779--794",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "6",

}

TY - JOUR

T1 - Review article

T2 - The management of steroid dependency in ulcerative colitis

AU - Porro, G. Bianchi

AU - Cassinotti, A.

AU - Ferrara, E.

AU - Maconi, G.

AU - Ardizzone, S.

PY - 2007/9

Y1 - 2007/9

N2 - Background: Approximately 20% of patients with ulcerative colitis have a chronic active disease often requiring several courses of systemic steroids in order to achieve remission, but followed by relapse of symptoms during steroid tapering or soon after their discontinuation. Although short term control of symptoms can be achieved with steroid treatment, this pattern of drug response, known as steroid-dependency, leads to important complications of the treatment, while a significant proportion of patients requires colectomy. Aim: To review the studies currently available specifically evaluating the management of steroid-dependent ulcerative colitis. Results: The clinical and biological mechanisms of steroid-dependency are not well understood compared with those determining steroid-refractoriness. Very few evidence-based data are available concerning the management of patients with steroid-dependent ulcerative colitis. The therapeutic role of aminosalicylates, thiopurines, methotrexate, infliximab, leukocyte apheresis and other drugs in the treatment of steroid-dependent ulcerative colitis are evaluated. Conclusions: Outcomes of studies in steroid-refractory patients may not be applicable to steroid-dependency. Trials are needed to define the correct approaches and new strategies to ameliorate the therapy of steroid-dependent ulcerative colitis.

AB - Background: Approximately 20% of patients with ulcerative colitis have a chronic active disease often requiring several courses of systemic steroids in order to achieve remission, but followed by relapse of symptoms during steroid tapering or soon after their discontinuation. Although short term control of symptoms can be achieved with steroid treatment, this pattern of drug response, known as steroid-dependency, leads to important complications of the treatment, while a significant proportion of patients requires colectomy. Aim: To review the studies currently available specifically evaluating the management of steroid-dependent ulcerative colitis. Results: The clinical and biological mechanisms of steroid-dependency are not well understood compared with those determining steroid-refractoriness. Very few evidence-based data are available concerning the management of patients with steroid-dependent ulcerative colitis. The therapeutic role of aminosalicylates, thiopurines, methotrexate, infliximab, leukocyte apheresis and other drugs in the treatment of steroid-dependent ulcerative colitis are evaluated. Conclusions: Outcomes of studies in steroid-refractory patients may not be applicable to steroid-dependency. Trials are needed to define the correct approaches and new strategies to ameliorate the therapy of steroid-dependent ulcerative colitis.

UR - http://www.scopus.com/inward/record.url?scp=34548324538&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548324538&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2036.2007.03334.x

DO - 10.1111/j.1365-2036.2007.03334.x

M3 - Article

C2 - 17767462

AN - SCOPUS:34548324538

VL - 26

SP - 779

EP - 794

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 6

ER -