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炎症性肠病中的皮质类固醇:它们仍然是一种治疗选择吗?

Corticosteroids in inflammatory bowel disease: Are they still a therapeutic option?

机构信息

Programa Enfermedad Inflamatoria Intestinal, Centro de Enfermedades Digestivas, Universidad de los Andes, Santiago, Chile.

Programa Enfermedad Inflamatoria Intestinal, Centro de Enfermedades Digestivas, Universidad de los Andes, Santiago, Chile; Sección de Gastroenterología, Departamento de Medicina Interna, Hospital San Juan de Dios, Facultad Medicina Occidente, Universidad de Chile, Santiago, Chile.

出版信息

Gastroenterol Hepatol. 2023 Nov;46(9):716-726. doi: 10.1016/j.gastrohep.2022.10.017. Epub 2022 Nov 11.

Abstract

Despite the development and incorporation of new therapeutic strategies, such as biologic therapy and small molecules, corticosteroids still play an important role in inducting inflammatory bowel diseases (IBD) remission. Variables like indicating the right doses at the right time, in adequate intervals, the security of these drugs and the pharmacological alternatives available must be considered by the providers when they are indicated to patients with IBD. Although the use of corticosteroids is considered as a marker of quality of care in patients with IBD, the use of these drugs in the clinical practice of IBD is far from being the correct one. This review article is not intended to be just a classic review of the indications for corticosteroids. Here we explain the scenarios in which, in our opinion, steroids would not be an appropriate option for our patients, as well as the most frequent mistakes we make in our daily practice when using them.

摘要

尽管新的治疗策略,如生物疗法和小分子药物的发展和应用,糖皮质激素在诱导炎症性肠病(IBD)缓解方面仍发挥着重要作用。提供者在为 IBD 患者开具这些药物时,必须考虑到在适当的时间间隔内给予正确剂量的安全性和可用的药物替代方案等变量。虽然糖皮质激素的使用被认为是 IBD 患者护理质量的标志,但这些药物在 IBD 的临床实践中的使用远非正确。本文不是一篇简单的糖皮质激素适应证的综述。在这里,我们解释了在我们看来,类固醇不适合我们患者的情况,以及我们在日常实践中使用类固醇时最常犯的错误。

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