Steroid usage patterns in inflammatory bowel illness are still not well understood in practical contexts. Exposure to steroids is linked to negative consequences and frequently signifies poorly managed illness. Thus, this study investigated in a large cohort of people with inflammatory bowel disease, patterns and determinants of steroid usage.
Over a three-year period, steroid exposure was investigated. The length of use was divided into four categories: short (1–28 days), moderate (29–56 days), extended (>56 days), and recency (during the last year, previous years, or no exposure). Multivariable logistic regression was used to evaluate associations with demographic and disease-related characteristics.
18.3% (n = 994) of 5436 individuals (median age 42 years, IQR 32–56) had been exposed to steroids. 50.2% were female, and 57.6% had Crohn's disease. When compared to ulcerative colitis, Crohn's disease was linked to decreased risks of both recent and protracted exposure (AOR 0.78, p = 0.037 and AOR 0.72, p = 0.001, respectively).
Both prolonged and recent exposure were more likely to occur in females (AOR 1.22, p = 0.048 and AOR 1.23, p = 0.041, respectively). When compared to persons over 70, young adults (20–29 years old) exhibited greater chances of recent and extended usage (AOR 6.59 and 9.12, respectively, p<0.001).
When compared to 5-aminosalicylic acid treatment alone, combination immunomodulator and advanced therapy usage was linked to a greater chance of both recent and extended use. The impact size of age upon diagnosis was low.
Overall, with over 20% of patients exposed throughout a three-year period, this real-world cohort research demonstrates that steroid usage is still prevalent in IBD. Younger patients, women, those with ulcerative colitis, and those receiving combination immunosuppressive and advanced therapy were more likely to use them. This suggests factors other than the severity of the illness, such as treatment delays and therapeutic inertia. While corticosteroids work well for short-term flare-ups, long-term usage can be avoided by promptly switching to steroid-sparing therapies.
Source:
Wu, R., Rivas, C., Su, W. K., Deschenes, R., Wilson, W., Pipicella, J. L., Connor, S. J., Andrews, J. M., & Crohn’s Colitis Cure (CCCure) Data Insights Program. (2025). Patterns and predictors of steroid use in a real-world inflammatory bowel disease cohort. JGH Open : An Open Access Journal of Gastroenterology and Hepatology, 9(12), e70308. https://doi.org/10.1002/jgh3.70308
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