Table 2.
Steroid Use, Steroid Dependency, Steroid Refractoriness, Excessive Steroid Use and Inappropriate Steroid Use at Baseline (Cohort 1) and after Physician Education (Cohort 2)
| Characteristic | Cohort 1 (Year 0) |
Cohort 2 (Year 1) |
|||||
|---|---|---|---|---|---|---|---|
| CD (n=660) | UC (n=1,025) | Total (n=1,685) | CD (n = 705) | UC (n = 944) | Total (n = 1,649) | ||
| Participants with steroid exposure, No. (%) | 45 (6.8) | 110 (10.7) | 155 (9.2) | 59 (8.4) | 101 (10.7) | 160 (9.7) | |
| Excess steroid use | 8 (1.2; 17.8) | 38 (3.7; 34.6) | 46 (2.7; 29.7) | 8 (1.1; 13.6) | 24 (2.5; 23.8) | 32 (1.9; 20.0) | |
| Inability to reduce the dose of steroids below the equivalent dose of prednisolone 10 mg/day within 3 months of starting steroids, without recurrent active disease | 5 (0.8; 11.1) | 11 (1.1; 10.0) | 16 (1.0; 10.3) | 5 (0.7; 8.5) | 12 (1.3; 11.9) | 17 (1.0; 10.6) | |
| Case continued steroid use due to recurrence of symptom(s) within 3 months after stopping steroids | 3 (0.5; 6.7) | 16 (1.6; 14.6) | 19 (1.1; 12.3) | - | - | - | |
| Use ≥ 2 steroid treatment courses within 1 year | 4 (0.6; 8.9) | 28 (2.7; 25.5) | 32 (1.9; 20.7) | 3 (0.4; 5.1) | 12 (1.3; 11.9) | 15 (0.9; 9.4) | |
| Case continued steroid use without step-up treatment in patients who have active disease despite prednisolone up to 1 mg/kg/day (30 mg) for a period of 4 weeks | 0 | 0 | 0 | - | - | - | |
| Participants with inappropriate steroid use | 3 (0.5; 6.7) | 13 (1.3; 11.8) | 16 (1.0; 10.3) | 3 (0.4; 5.1) | 9 (0.1; 8.9) | 12 (0.7; 7.5) | |
| Case did not receive step-up treatment in patients with inability to reduce the dose of steroids below the equivalent dose of prednisolone 10 mg/day within 3 months of starting steroids, without recurrent active disease | 3 (0.5; 6.7) | 12 (1.2; 10.9) | 15 (0.9; 9.7) | 1 (0.1; 1.7) | 5 (0.5; 5.0) | 6 (0.4; 3.8) | |
| Case did not receive step-up treatment in patients with recurrence of symptoms within 3 months after stopping steroids | 1 (0.2; 2.2) | 2 (0.2; 1.8) | 3 (0.2; 1.9) | 1 (0.1; 1.7) | 0 | 1 (0.1; 0.6) | |
| Case did not receive step-up treatment in patients who used ≥ 2 steroid treatment courses within 1 year | 1 (0.2; 2.2) | 0 | 1 (0.1; 0.7) | 2 (0.3; 3.4) | 5 (0.5; 5.0) | 7 (0.4; 4.4) | |
| Case continued steroid use without step-up treatment in patients who have active disease despite prednisolone up to 1 mg/kg/day (30 mg) for a period of 4 weeks | 0 | 0 | 0 | 0 | 0 | 0 | |
| Steroid dependency | 26 (3.9; 57.8) | 76 (7.4; 69.1) | 102 (6.1; 65.8) | 14 (2.0; 23.7) | 31 (3.3; 30.7) | 45 (2.7; 28.1) | |
| Inability to reduce the dose of steroids below the equivalent dose of prednisolone 10 mg/day within 3 months of starting steroids, without recurrent active diseasea | 5 (0.8; 11.1) | 11 (1.1; 10.0) | 16 (1.0; 10.3) | 5 (0.7; 8.5) | 12 (1.3; 11.9) | 17 (1.0; 10.6) | |
| Recurrence of symptoms within 3 months after stopping steroids | 21 (3.2; 46.7) | 54 (5.3; 49.1) | 75 (4.5; 48.4) | 9 (1.3; 15.3) | 17 (1.8; 16.8) | 26 (1.6; 16.3) | |
| Use of ≥ 2 steroid treatment courses within 1 year | 4 (0.6; 8.9) | 28 (2.7; 25.5) | 32 (1.9; 20.7) | 3 (0.4; 5.1) | 12 (1.3; 11.9) | 15 (0.9; 9.4) | |
| Steroid refractorinessb | 20 (3.0; 44.4) | 43 (4.2; 39.1) | 63 (3.7; 40.7) | 6 (0.9; 10.2) | 6 (0.6; 5.9) | 12 (0.7; 7.5) | |
Values are presented as number (percentage of all participants in column; percentage of all participants with steroid exposure) unless otherwise indicated.
a
Below the equivalent dose of prednisolone 10 mg/day within 3 months of starting steroids.
b
Patients with active disease despite prednisolone use up to 1 mg/kg/day (30 mg) for 4 weeks.
CD, Crohn's disease; UC, ulcerative colitis.