Budesonide in the Treatment of Refractory Celiac Disease

Abstract

Budesonide may be of value in the management of refractory celiac disease.

Collagenous sprue is not always associated with dismal outcomes: a clinicopathological study of 19 patients

“…Used widely in Crohn's disease, it has been shown to benefit patients with poorly responsive celiac disease. 42 The etiology of collagenous sprue is not known. Increases in procollagen I and tissue inhibitor of metalloproteinase-1 mRNAs, unopposed by increases in mRNA levels of matrix metalloproteinases 1 and 3 (key enzymes of extracellular matrix degradation), have been reported in collagenous sprue.…”

Celiac Disease and Autoimmunity in the Gut and Elsewhere

“…Budesonide is effective in improving clinical symptoms in RCD I and II groups, though histological recovery of the small bowel architecture was not observed in one recent study. [66] Budesonide has significant first-pass metabolism, largely minimizing the systemic side effects associated with chronic steroid therapy.…”

Complete Resolution of Type 1 Refractory Celiac Disease after Combined Treatment with Budesonide and Azathioprine: A Case Report and Literature Review

“…In addition, methodological quality of published studies is far from ideal, due to logical difficulties in recruiting patients and ethical aspects. Typically, prednisone (0.5-1 mg/kg/day) or budesonide (9mg/day) have been used as initial treatment options [12,13]. Budesonide seems to be a more attractive alternative, since it shows a better safety profile when compared to prednisone, due to its extensive first-pass metabolism.…”