An international panel of 45 IBD experts identified inconsistent corticosteroid tapering and maintenance as issues to trial validity and patient safety.

Using a Delphi process, the group developed consensus recommendations to harmonize corticosteroid management in moderate-to-severe IBD trials.

The panel advised at least two weeks of stable dosing before screening and initiation of tapering within two weeks of induction using a 5 mg/week prednisone-equivalent schedule.

Enteric- or colonic-release budesonide should not be tapered, and participants receiving intravenous steroids during screening should be excluded.

Short, fixed-duration tapering regimens are preferred over open-ended approaches, with all corticosteroid use documented in protocols.

The required duration of steroid withdrawal for defining corticosteroid-free remission remains unresolved.

Source: United European Gastroenterology (UEG) Week 2025