Steroid use and misuse: a key performance indicator in the management of IBD

Frontline Gastroenterol. 2020 Apr 2;12(3):207-213.doi: 10.1136/flgastro-2019-101288. eCollection 2021.

Jonathan Blackwell 1 2Christian Selinger 3 4Tim Raine 5Gareth Parkes 6Melissa A Smith 7 8Richard Pollok 1 9


Author information

  • 1Department of Gastroenterology, St George's Hospitals NHS Foundation Trust, London, UK.
  • 2School of Public Health, Imperial College London, London, UK.
  • 3Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • 4The Leeds Institute of Research at St James', University of Leeds, Leeds, UK.
  • 5Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • 6Department of Gastroenterology, Royal London Hospital, London, UK.
  • 7Digestives Diseases Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
  • 8Department of Gastroenterology, Brighton and Sussex Medical School, Brighton, UK.
  • 9Division of Infection and Immunity, St George's University London, London, UK.


Corticosteroids remain an important tool for inducing remission in inflammatory bowel disease (IBD) but they have no role in maintenance of remission. The significant adverse side effect profile of these drugs means their use should be avoided where possible or measures taken to reduce their risk. Despite an expanding array of alternative therapies, corticosteroid dependency and excess remain common. Appropriate steroid use is now regarded a key performance indicator in the management of IBD. This article aims to outline indications for corticosteroid use in IBD, their risks and strategies to reduce their use and misuse.

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