Papi et al evaluated the response of patients with Crohn's disease to corticosteroid therapy. They classified the response shown by the patient during and after the steroid therapy The authors are from hospitals in Rome and Bari, Italy.


Patient selection - Crohn's disease with:

(1) first course of corticosteroid therapy

(2) clinical remission achieved with an oral dose of 0.8 to 1.0 mg prednisone per kg per day

(3) gradual tapering of corticosteroid dose over 12 to 16 weeks

(4) maintenance on oral aminosalicylic acid 2.4 to 4.0 grams per day


Followup: up to 12 months after corticosteroid therapy



steroid refractory

failure to respond to oral dose of corticosteroid within 3 weeks

steroid dependent

EITHER 2 consecutive early relapses during corticosteroid weaning period OR relapse within 4 weeks of corticosteroid withdrawal (early relapse)

steroid-induced remission

complete clinical remission at 4 weeks after discontinuation of corticosteroid therapy

clinical relapse

recurrence of symptoms after achieving remission



• A remission was defined as the CDAI (see above) < 150.

• If a relapse occurred while weaning then the dose was adjusted to achieve control.





further corticosteroid therapy not required


oral corticosteroid therapy required


hospitalization with intensive intravenous corticosteroid therapy


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