Corticosteroids and antibodies to tumor necrosis factor (anti-TNF) are mainstays of treatment of acutely active IBD and while anti-TNF therapy is indicated for maintenance therapy, chronic corticosteroid therapy is associated with known significant risks. Nonetheless, chronic or recurrent corticosteroid treatment in IBD is common. In this edition of the journal Lewiset al.use Medicaid and Medicare databases to contrast adverse outcomes in persons with IBD and either corticosteroid or anti-TNF use. Compared to high dose corticosteroid use, anti TNF therapy is associated with less risk for death in Crohn's disease but no statistical difference in death outcomes in ulcerative colitis. The adverse effects of corticosteroids are well known yet vigilance is still required to ensure their use is limited to the short term.
1Department of Internal Medicine, University of Manitoba IBD Clinical and Research Centre and Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Correspondence: Professor Charles N. Bernstein, MD, Department of Internal Medicine, University of Manitoba IBD Clinical and Research Centre, 804F-715 McDermot Avenue, Winnipeg, Manitoba R3E 3P4, Canada. E mail: Charles.firstname.lastname@example.org
Received 20 December 2017; accepted 3 January 2018