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 20 February 2018

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News

Should physicians consider switching from corticosteroids for long-term treatment of Crohn's disease?

Most Crohn's disease patients in the US continue to be treated with corticosteroids despite the emergence of new therapies, according to a survey.

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The telephone survey of 157 gastroenterology specialists found that 88% choose the traditional steroid treatment for severe flare ups.

Dr Charles Sninsky said doctors who continued to use steroids needed to monitor patients carefully for the emergence of long-term side effects such as osteoporosis and hypertension.

The survey was conducted by Yankelovich Partners with a grant from Centocor Inc. and then analysed by Dr Sninsky and colleagues at Vanderbilt University Medical Center, Nashville, Tennessee, US.

Twenty per cent of doctors in the survey said they would be prepared to keep patients on steroids for a year. On average doctors cited nine months as the length of time they would continue to prescribe the drugs to patients in remission.

Dr Sninsky, Associate Director of Gastroenterology, Hepatology and Nutrition at the Medical Center, said: "The bottom line is that steroids are generally not effective for the extended maintenance of Crohn's disease, and therefore alternative therapies should be explored.

"Our major concern is a flare-up of Crohn's symptoms when steroids are reduced. However, some of the symptoms that patients experience as they withdraw from steroids, like fatigue and joint pain, are in part due to the steroid use itself and a resulting adrenal insufficiency.

"These symptoms can decrease as patients are tapered off steroids. More importantly, these and other symptoms can also be avoided by alternative therapies.

"The good news for all Crohn's patients is there are newer, safer and well-tolerated medications available today, like infliximab, that are emerging as proven treatment options that not only provide quick relief of symptoms without the side effects of steroids, but also help in healing the intestines.

"What's more, existing therapies such as immunomodulators may also be explored as effective alternatives for Crohn's patients in remission."

Report Copyright: Englemed Health News at http://www.internationalmedicalnews.com

Vanderbilt University Medical Center
19 October 2000

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