Letter: corticosteroid use alongside tofacitinib in OCTAVE Open. Authors' reply

end point. Only five patients in the included patient populations were on corticosteroids at the baseline of OCTAVE Open, and the authors describe a mandatory steroid taper. However, they do not make it explicit whether steroids could be re-introduced at a later time point without influencing the assessment of remission. Chronic corticosteroid use has been associated with an increased risk of death and major adverse cardiovascular events as compared with TNFi therapy.2 Similarly, in a retrospective study using the Veterans Affairs database, Waljee et al3 observed that of patients with IBD receiving corticosteroids 17% received prolonged treatment which was associated with a higher risk of serious infections, thromboembolic events and pathologic fractures. Thus, the risk of serious infections associated with the corticosteroids should be considered, and more information about overall corticosteroids therapy in this study would be helpful.