Six-Year Observation Data Reveal Reduction in Concomitant Steroid Overuse for Inflammatory Bowel Disease in Germany.

Abstract

Background: Maintenance and/or prolonged treatment with oral corticosteroid (OCS) in inflammatory bowel disease (IBD) is not recommended, yet remains common. This study assessed concomitant OCS use and overuse in IBD patients in Germany from 2017 to 2022.

Methods: We retrospectively analyzed German claims data (2017-2022). Patients over 18 years of age with continuous insurance and at least s2 quarterly diagnoses of Crohn's disease (CD) or ulcerative colitis (UC) within 2 years were included. To increase the diagnostic certainty and clinical relevance, only patients with IBD who were currently receiving any form of IBD therapy were included in the analysis. OCS overuse was defined as receiving ≥2 OCS prescriptions within 1 year alongside other IBD medications.

Results: The study identified 9407 patients with confirmed CD and 11 772 patients with confirmed UC who were treated with IBD medications excluding OCS monotherapy within the observation period. Among those, 42.8% of CD patients and 39.0% of UC patients were treated with concomitant OCS (CD vs. UC, P < .0001), while 31.3% of CD patients and 29.4% of UC patients exhibited concomitant OCS overuse (CD vs. UC, P < .01). Concomitant OCS use and overuse were more common among younger age groups (P < .01). OCS use and OCS overuse decreased significantly (P < .0001) from 2017 to 2022.

Conclusions: This study provides real-world insights into the patterns of OCS use and overuse in IBD patients. The continued reliance on OCS is highlighted, particularly in CD patients and younger age groups. Notably, steroid overuse has decreased significantly over the last 6 years.