A Controlled Trial of Beclomethasone Versus Betamethasone Enemas in Distal Ulcerative Colitis

Halpern, Zamir; Sold, O; Baratz, M; Konikoff, Fred M.; Halak, Aharon; Gilat, T

doi:10.1097/00004836-199102000-00009

Cited by 44 publications

(20 citation statements)

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“…These trials showed that topical administration of a BDP enema was as effective as first-generation beclomethasone phosphate and was preferable in terms of tolerability, as it did not affect adrenocortical function in patients with distal ulcerative colitis ( Table 2) [Bansky et al 1987;Halpern et al 1991]. Furthermore, topical BDP enema was as effective as mesalamine foam in patients with mild-to-moderate distal ulcerative colitis (Table 2) [Biancone et al 2007].…”

Section: Efficacy In Ulcerative Colitismentioning

confidence: 99%

“…As a second-generation glucocorticosteroid with much lower systemic absorption, it is associated with significantly fewer glucocorticosteroid adverse events than first-generation betamethasone phosphate, particularly with respect to hypothalamicpituitary-adrenal axis suppression [Bansky et al 1987;Halpern et al 1991]. The most commonly reported adverse events associated with 6 months' administration of BDP, however, were gastrointestinal related, including moon face, hyperthyroidism and Cushing's syndrome [Prantera et al 2011].…”

Section: Tolerabilitymentioning

confidence: 99%

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Glucocorticosteroids in the treatment of inflammatory bowel disease and approaches to minimizing systemic activity

Prantera

Marconi

2013

Therap Adv Gastroenterol

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Inflammatory bowel diseases (IBDs) are a group of inflammatory conditions characterized by chronic, uncontrolled inflammation of the gastrointestinal tract. Reported prevalence is high in the United States and northern Europe, while the incidence varies greatly across the rest of Europe. Glucocorticosteroids are the standard treatment for IBD, but due to adverse events their use can be limited. However, new formulations of glucocorticosteroids have been developed to reduce systemic activation. The aim of this review was to assess and summarize the efficacy and safety of new formulations of glucocorticosteroids. A MEDLINE search identified publications focused on new formulations of nonsystemic steroidbased drugs for IBD and benefits and limitations of each of the new glucocorticosteroid formulations were identified. Budesonide has good efficacy and is an established treatment for Crohn's disease; it has been shown to be beneficial for the induction of remission in these patients, although it is not recommended for the maintenance of induced remission. Glucocorticosteroids are not recommended for the maintenance of remission in patients with IBD. However, a recent study suggested that beclomethasone dipropionate may be effective for prolonged treatment in patients in the postacute phase of Crohn's disease who were treated with a short course of systemic steroids. The efficacy of fluticasone propionate and prednisolone metasulphobenzoate in IBD is not well established given the small number of patients enrolled in the few published clinical trials. While the tolerability of these glucocorticosteroids is favourable, more research comparing these new agents with traditional systemic glucocorticosteroids is warranted.

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Section: Efficacy In Ulcerative Colitismentioning

confidence: 99%

Section: Tolerabilitymentioning

confidence: 99%

Glucocorticosteroids in the treatment of inflammatory bowel disease and approaches to minimizing systemic activity

Prantera

Marconi

2013

Therap Adv Gastroenterol

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“…In patients with UC, BDP enemas have a similar efficacy to mesalazine and other steroid enemas in inducing remission of the disease [50,51,52,53,54,55,56], with a superiority of a combination of BDP and mesalazine enemas over single-agent therapy [57]. Oral BDP is effective in improving clinical, endoscopic and biopsy scores in patients with mild-to-moderate left-sided and extensive UC [58,59,60,61,62].…”

Section: Resultsmentioning

confidence: 99%

Second-Generation Corticosteroids for the Treatment of Crohn’s Disease and Ulcerative Colitis: More Effective and Less Side Effects?

Cassan¹,

Fiorino²,

Danese³

2012

Dig Dis

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Background/Aims: Systemic corticosteroids are highly effective at inducing clinical remission in cases of acute exacerbation of Crohn’s disease (CD) and ulcerative colitis (UC); however, their use is limited by their frequent and sometimes severe side effects. Thus, a second generation of corticosteroids with less systemic effects has been developed. This review analyzed all of the studies on the new formulations of steroids with limited absorption (budesonide, budesonide MMX®, beclomethasone dipropionate and erythrocyte-mediated delivery of dexamethasone) in patients with CD and UC. Methods: All relevant articles published in English between September 1960 and April 2011 were reviewed. Results: Budesonide is superior to placebo, and as effective as systemic corticosteroids in inducing clinical remission in patients with ileo-colonic CD, but evidence of mucosal healing is limited. When administered as an MMX formula, budesonide can also effectively induce clinical remission in patients with UC, but budesonide alone is not effective in maintaining clinical remission in CD or UC. Beclomethasone dipropionate seems to be effective in patients with mild-to-moderate left-sided and extensive UC, while data on erythrocyte-mediated delivery of dexamethasone are encouraging but still limited. The safety profile for all these products is good but more studies are needed. Conclusion: Steroids remain the mainstay for the induction of clinical remission in cases of acute relapse of both CD and UC. Second-generation corticosteroids are an interesting alternative, with the advantage of high topical activity, less systemic toxicity and limited side effects.

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“…In contrast to betamethasone, beclomethasone dipropionate did not cause steroid-related side-effects [55]. Beclomethasone dipropionate tablets are currently being developed for oral treatment of IBD.…”

Section: Corticosteroidsmentioning

confidence: 99%

“…Absorption from the intestine is less than 50%, which is likely to reflect the drug's low water solubility, which largely limits its uptake via the intestinal mucosa. In a pilot study on the use of 20 mg of fluticasone propionate orally for three weeks in the treatment of mild to moderately active Crohn's disease, Carpani de Kaski et al reported a significant drop in the Crohn's Disease Activity Index (CDAI), no effect on plasma cortisol levels, and no severe side-effects [55].…”

Section: Corticosteroid Preparations For the Treatment Of Inflammatormentioning

confidence: 99%

New developments in the pharmacotherapy of inflammatory bowel disease

Jw¹

1992

Pharmaceutisch Weekblad Scientific Edition

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In this article the clinical features and aetiology of inflammatory bowel diseases are described and current pharmacotherapeutic possibilities are explored. Also reviewed are recent developments and future prospects for the pharmacotherapy of inflammatory bowel diseases, including aminosalicylates, corticosteroids, immunosuppressants, lipoxygenase inhibitors, fish oil, sucralfate, bismuth compounds, free radical scavengers, (hydroxy)chloroquine, sodium cromoglycate and methotrexate.

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A Controlled Trial of Beclomethasone Versus Betamethasone Enemas in Distal Ulcerative Colitis

Cited by 44 publications

References 0 publications

Glucocorticosteroids in the treatment of inflammatory bowel disease and approaches to minimizing systemic activity

Glucocorticosteroids in the treatment of inflammatory bowel disease and approaches to minimizing systemic activity

Second-Generation Corticosteroids for the Treatment of Crohn’s Disease and Ulcerative Colitis: More Effective and Less Side Effects?

New developments in the pharmacotherapy of inflammatory bowel disease

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