What clinical criteria define steroid‑dependent UC
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One operational definition from a randomised trial required steroid therapy ≥10 mg/day during the preceding six months, with at least two failed attempts to discontinue steroids 1. More broadly, an effective therapy in this subset is one that can establish remission, prevent relapse, and limit corticosteroid exposure 2. 1–3
What is known: - A randomised controlled trial defined steroid dependence as a requirement for steroid therapy ≥10 mg/day over the preceding six months, with at least two attempts to discontinue. 1 - Cohort and review work treats steroid dependency and steroid refractoriness as distinct subsets that should not be generalized between. 2,3
What is unknown / caveats: - Excerpts give one trial-specific threshold, not a single universally accepted consensus definition - Steroid dependency is repeatedly distinguished from steroid refractoriness but a formal refractory definition is not provided here - The excerpts note that mechanisms and definitions of steroid dependency are not well understood and that evidence-based data are sparse.
## References
1. Ardizzone S, Maconi G, Russo A, Imbesi V, Colombo E, Bianchi Porro G. Randomised controlled trial of azathioprine and 5-aminosalicylic acid for treatment of steroid dependent ulcerative colitis. Gut. 2006;55:47-53. PMID: 15972298.
2. Bianchi Porro G, Cassinotti A, Ferrara E, Maconi G, Ardizzone S. Review article: the management of steroid dependency in ulcerative colitis. Aliment Pharmacol Ther. 2007;26:779-94. PMID: 17767462.
3. Mañosa M, García V, Castro L, García-Bosch O, Chaparro M, Barreiro-de Acosta M, Carpio D, Aguas M. Methotrexate in ulcerative colitis: a Spanish multicentric study on clinical use and efficacy. J Crohns Colitis. 2011;5:397-401. PMID: 21939912.
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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._
Reviewer notes