S114 Assessment of Corticosteroid Use as a Marker of Quality-of-Care in the Management of Inflammatory Bowel Disease

Abstract

Background: Despite the development of new therapeutic strategies, corticosteroids still play a role in the induction of Inflammatory Bowel Disease (IBD) remission. However, often these drugs are misused. Methods: Descriptive, retrospective observational study of patients with IBD under follow-up in the Inflammatory Bowel Disease Program of Clínica Universidad de los Andes (Chile) during the period of January 2021-August 2022. The objectives were to assess the dose and duration of corticosteroid therapy, and the subsequent change in treatment in patients with IBD. The statistical analysis, descriptive and association statistics x2 with P< 0.05 were used. Results: Four hundred and thirty-two IBD patients were included, 63% of them women, with a median age of 42 years (14-94), 66% with ulcerative colitis (UC). Sixty-six percent of patients have received corticosteroids during the course of their disease (range 1-9 times) for a median of 12 weeks (2-48 weeks), prednisone being the most frequently used corticosteroid (53%). Seventy-seven percent of patients have received treatment for >3 months or in supratherapeutic doses (more than 1 mg/Kg, range 40-60 mg of prednisone). There was a change in treatment in 82% of these patients. During the Program’s follow-up, 10% have received corticosteroids (71% prednisone, 29% budesonide) with no differences according to IBD type, gender, age or type of treatment. No patient has received corticosteroids for >3 months or in supratherapeutic doses in our Inflammatory Bowel Disease Program. Two percent developed corticosteroid dependency and in 90% there was a change of treatment. Conclusion(s): This study validates the assessment of the use of corticosteroids as a marker of quality of care in IBD. The management of these patients through a specialized program could reduce the excessive use of corticosteroids.