Corticosteroids in Inflammatory Bowel Disease Patients: A Practical Guide for Physicians

Author(s): Maria Carla Di Paolo, Cristiano Pagnini*, Maria Giovanna Graziani

Journal Name: Current Reviews in Clinical and Experimental Pharmacology
(Formerly Current Clinical Pharmacology)

Volume 16 , Issue 3 , 2021


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Abstract:

Inflammatory Bowel Diseases (IBDs) are chronic conditions characterized by unknown etiology and pathogenesis with deregulation of mucosal immunity. Among possible treatments, corticosteroids, already available from the ’50s, are still the mainstay of treatment for moderate to severe disease. Nonetheless, the use of steroids is still largely empirical and solid evidence about therapeutic schemes are lacking. Moreover, due to the important side-effects and for the unsatisfactory impact on the long-term natural history of the disease, the steroid-sparing has become an important therapeutic goal in IBD management. Besides conventional steroids, the so-called “low bioavailability” steroids, which are steroids with high affinity for peripheral receptors and elevated hepatic first-pass metabolism, have demonstrated efficacy and a more favorable safety profile. In the present review of the literature evidence of efficacy and safety of conventional and low bioavailability steroids in IBD patients are evaluated, and practical suggestions for a correct use in clinical practice are presented according to the current clinical guidelines.

Keywords: Inflammatory bowel disease, corticosteroids, ulcerative colitis, crohn’s disease, peripheral receptors, low bioavailability steroids.

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Article Details

VOLUME: 16
ISSUE: 3
Year: 2021
Published on: 14 July, 2020
Page: [210 - 218]
Pages: 9
DOI: 10.2174/1574884715666200714114044
Price: $65

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