Budesonide for ulcerative colitis

Marín-Jiménez, Ignacio; Peña, Amado Salvador

doi:10.4321/s1130-01082006000500007

Cited by 16 publications

(11 citation statements)

References 40 publications

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“…Evidence suggests that topical budesonide does not accumulate in the body and compared with other corticosteroids, reaches more central parts of the colon and shows less suppression of plasma cortisol, without diminished efficacy. (48) A study comparing oral budesonide and prednisone showed similar efficacy rates in active and extensive UC. (49) A Cochrane review of budesonide in CD suggested that it may have lower short-term efficacy than other corticosteroids but fewer adverse events.…”

Section: Medical Management In Elderly Ibd Patientsmentioning

confidence: 99%

Management of Inflammatory Bowel Disease in the Elderly Patient

Ananthakrishnan

Donaldson

Lasch

et al. 2017

Inflammatory Bowel Diseases

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The population of older patients with inflammatory bowel disease (IBD) continues to grow, partly reflecting the aging global population in general. The debilitating effects of IBD compound age-related decrements in health and functional capacity, and make the medical management of older patients with Crohn’s disease and ulcerative colitis distinctly challenging to clinicians. Here, we review the recent literature describing the pharmacologic management of IBD in this population, with focus on the safety, tolerability, and efficacy of common treatment options, such as steroids, immunomodulators, tumor necrosis factor-α antagonists, and integrin antagonists; surgical interventions in older patients are also discussed. Few studies have systematically and prospectively evaluated the clinical challenges in the medical management of IBD in this patient population, leaving a limited evidence base to which clinicians can turn to for guidance. Treatment patterns may thus be suboptimal. For example, prolonged steroid use in the elderly was found to be common, causing significant morbidity from side effects in a particularly vulnerable population. Finally, within the context of a limited evidence base, we discuss common treatment scenarios to define the parameters within which physicians can individualize care for older patients with IBD. Overall, older IBD patients are at higher risk of adverse events and less treatment responsiveness compared with younger patients, underscoring the need for future studies to fully characterize appropriate treatment courses for this population.

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Section: Medical Management In Elderly Ibd Patientsmentioning

confidence: 99%

Management of Inflammatory Bowel Disease in the Elderly Patient

Ananthakrishnan

Donaldson

Lasch

et al. 2017

Inflammatory Bowel Diseases

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“…The first trial published about the use of oral budesonide in CD patients was performed by Lofberg et al in 1993 12. Budesonide is available in three oral dose forms (Table 1): a controlled ileal release form, a pH-dependent release formulation, and a MMX formulation 8,13…”

Section: Pharmacologymentioning

confidence: 99%

“…A pH-dependent release formulation (Budenofalk®, Dr Falk Pharma, Freiburg, Germany) is an enteric coated locally acting glucocorticoid preparation whose pH- and time-dependent coating enables its release into the ileum and ascending colon. This oral formulation consists of a capsule containing L, S, LS, and RS Eudragit® granules that dissolve at pH values above 6.4 13,14…”

Section: Pharmacologymentioning

confidence: 99%

Long-term safety and efficacy of budesonide in the treatment of ulcerative colitis

Iborra¹,

Alvarez-Sotomayor²,

Nos³

2014

CEG

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Ulcerative colitis (UC) is a chronic, relapsing, and remitting inflammatory disease involving the large intestine (colon). Treatment seeks to break recurrent inflammation episodes by inducing and maintaining remission. Historically, oral systemic corticosteroids played an important role in inducing remission of this chronic disease; however, their long-term use is limited and can lead to adverse events. Budesonide is a synthetic steroid with potent local anti-inflammatory effects and low systemic bioavailability due to high first-pass hepatic metabolism. Several studies have demonstrated oral budesonide’s usefulness in treating active mild to moderate ileocecal Crohn’s disease and microscopic colitis and in an enema formulation for left sided UC. However, there is limited information regarding oral budesonide’s efficacy in UC. A novel oral budesonide formulation using a multimatrix system (budesonide-MMX) to extend drug release throughout the colon has been developed recently and seems to be an effective treatment in active left sided UC patients. This article summarizes budesonide’s long-term safety and efficacy in treating UC.

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“…These advantages made this drug a standard drug for the localized treatment of inflammatory bowel disease (1,2). BUD is currently marketed in several different commercial forms, as oral controlled-ileal-release formulations targeted at the distal ileum and right-sided colonic region in Crohn's disease, or as enema for the treatment of left-sided ulcerative colitis (UC) (3). However, no BUD formulation is available for the oral treatment of UC (3).…”

mentioning

confidence: 99%

“…BUD is currently marketed in several different commercial forms, as oral controlled-ileal-release formulations targeted at the distal ileum and right-sided colonic region in Crohn's disease, or as enema for the treatment of left-sided ulcerative colitis (UC) (3). However, no BUD formulation is available for the oral treatment of UC (3). It seems that rapid presystemic elimination of BUD in hepatocytes and in epithelial cells of the small intestine wall prevents sufficient bioavailability in colonic mucosa (4,5).…”

mentioning

confidence: 99%

Colon specific delivery of budesonide based on triple coated pellets: in vitro/in vivo evaluation

Varshosaz¹,

Emami²,

Tavakoli³

et al. 2012

Acta Pharmaceutica

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Three layered pellets of budesonide were prepared for colon delivery by the extrusion-spheronization method. The coatings consisted of hydroxypropylmethyl cellulose (HPMC) (as barrier layer), Eudragit E (as rate controlling layer) and hydroxypropylmethyl cellulose acetate succinate (HPMC AS) (as enteric layer). The rate controlling layer was further modified using various pore formers. Dissolution studies were carried out at pH 1.2, 7.4 and 6.8. Pellet core composition and type and level of pore former affected the drug release from pellets. Pellets containing 20 % (m/m) citric acid in the cores coated with HPMC at a coating level of 6 % (m/m), Eudragit E containing Avicel RC 581 (30 %) as pore former at a coating level of 30 % (m/m) and HPMC AS at a coating level of 15 % (m/m) had the best release profiles. These pellets showed promising results in alleviating the conditions of an experimental model of colitis induced by trinitrobenzenesulfonic acid in rats.

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Budesonide for ulcerative colitis

Cited by 16 publications

References 40 publications

Management of Inflammatory Bowel Disease in the Elderly Patient

Management of Inflammatory Bowel Disease in the Elderly Patient

Long-term safety and efficacy of budesonide in the treatment of ulcerative colitis

Colon specific delivery of budesonide based on triple coated pellets: in vitro/in vivo evaluation

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