Corticosteroid Use in a Prospective, Community-Based Cohort of Newly Diagnosed Inflammatory Bowel Disease Patients.

Abstract

Systemic corticosteroids (CS) are a mainstay of treatment for patients with newly diagnosed inflammatory bowel disease (IBD). Previous population-based studies report CS exposure rates range from 39 to 75% within the first year of diagnosis with surgical resection rates as high as 13-18% in the same time frame. These reports represent an older cohort of patients enrolled over prolonged periods of time and do not necessarily reflect current treatment approaches. We examine CS use during the first year of IBD diagnosis in a community-based, inception cohort. Data were derived from the Ocean State Crohn's and Colitis Area Registry (OSCCAR), a prospective inception cohort of IBD patients who are residents of Rhode Island. A total of 272 patients were included in the current analyses. Overall, 60% of Crohn's disease and 57% of ulcerative colitis patients were exposed to at least one course of CS during year 1 of study enrollment. Most notably, only 2% of patients (n=5) required a surgical resection. In this community-based cohort, 59% of patients were exposed to at least one course of CS during their first year of enrollment. In contrast to previous studies, OSCCAR represents a more modern cohort of patients. While steroid exposure rates were similar or slightly higher than those in previous reports, we observed a low rate of surgical resection. As our cohort ages, future analysis will focus on the role more contemporary agents may play on the low rates of surgery we observed.