Clinical Gastroenterology Vol.27 No.1(4)

Theme Current Therapy of IBD
Title Glucocorticoid Therapy of Crohnʼs Disease
Publish Date 2012/01
Author Ken Sugimoto The First Department of Medicine, Hamamatsu University School of Medicine
Author Kentarou Ikeya Centre for Gastroenterology and Inflammatory Bowel Disease Research, Hamamatsu South Hospital
Author Tomohiro Terai The First Department of Medicine, Hamamatsu University School of Medicine
Author Takayuki Iida Centre for Gastroenterology and Inflammatory Bowel Disease Research, Hamamatsu South Hospital
Author Hiroyuki Hanai Centre for Gastroenterology and Inflammatory Bowel Disease Research, Hamamatsu South Hospital
[ Summary ] For decades, glucocorticoids have served as major medications for achieving remission of active Crohnʼs disease. However, recently, anti-TNF-alpha monoclonal antibodies, such as infliximab, have significantly impacted therapeutic strategies for Crohnʼs disease. Due to serious adverse side effects associated with glucocorticoids the use of these medications for the treatment of Crohnʼs disease is declining. Likewise, severe adverse side effects related to potent biologics and immunomodulators have raised serious concerns. Additionally, some fraction of patients are intolerant to biologics or fail to show response to these medications. Therefore, the use of glucocorticoids as second line medications, following nutritional therapy for inducing remission, have been thought but have yet to become routine treatment tools. Finally, there is no statistically significant difference between glucocorticoids and placebos in terms of preventing relapse of quiescent Crohnʼs disease once induced remission has been achieved. Therefore, glucocorticoids cannot be recommended as a maintenance therapy for Crohnʼs disease.
back