Oral budesonide in gastrointestinal and liver disease: A practical guide for the clinician. Issue 9 (2nd May 2018)

• Record Type: Journal Article
• Authors: Miehlke, Stephan; Acosta, Manuel Barreiro‐de; Bouma, Gerd; Carpio, Daniel; Magro, Fernando; Moreels, Tom; Probert, Chris
• Is Part Of: Journal of gastroenterology and hepatology. Volume 33:Issue 9(2018)
• Page Start: 1574
• Page End: 1581
• Publication Date: 2018-05-02
• Subjects: autoimmune liver disease -- Budenofalk -- budesonide -- Cortiment -- Crohn's disease -- Entocort -- inflammatory bowel disease -- microscopic colitis -- tapering -- ulcerative colitis; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.14151
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Oral budesonide is a second‐generation steroid that allows local, selective treatment of the gastrointestinal tract and the liver, minimizing systemic exposure. The results of randomized trials comparing budesonide versus placebo or active comparators have led to expert recommendations that budesonide be used to treat mild or moderate active ileocecal Crohn's disease, microscopic colitis (including both collagenous and lymphocytic colitis), ulcerative colitis, and non‐cirrhotic autoimmune hepatitis. The mechanism of budesonide action obviates the need for dose tapering due to safety reasons after induction therapy. Where low‐dose budesonide is used to maintain remission, usually in microscopic colitis, it does not appear to have adverse safety implications other than slight reductions in cortisol levels on rare occasions. As a gut‐selective and liver‐selective corticosteroid, budesonide offers an appealing alternative to conventional systemic glucocorticoids in diseases of these organs.