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It is unclear whether adherence to prescribing standards has been achieved in inflammatory bowel disease (IBD).

To determine how prescribing of 5‐aminosalicylates (5‐ASAs), steroids and thiopurines has changed in response to emerging evidence.

We examined trends in oral and topical therapies in 23 509 incident IBD cases (6997 with Crohn's disease and 16 512 with ulcerative colitis) using a nationally representative sample between 1990 and 2010. We created five eras according to the year of diagnosis: era 1 (1990–1993), era 2 (1994–1997), era 3 (1998–2001), era 4 (2002–2005) and era 5 (2006–2010). We calculated the proportion of patients treated with prolonged 5‐ASAs (>12 months) and steroid dependency, defined as prolonged steroids (>3 months) or recurrent (restarting within 3 months) steroid exposure. We calculated the cumulative probability of receiving each …