Budesonide Suppositories Are Effective and Safe for Treating Acute Ulcerative Proctitis

Kruis, Wolfgang; Нешта, В. В.; Pesegova, Marina; Алексеева, О. П.; Андреев, П. С.; Datsenko, Oleksii; Levchenko, Olena; Абдулхаков, С. Р.; Lozynskyy, Yuriy; Mostovoy, Yu. M.; Soloviev, Konstantin; Dorofeyev, A. E.; Stieß, Michael; Greinwald, Roland; Mohrbacher, Ralf; Siegmund, Britta

doi:10.1016/j.cgh.2018.04.027

Cited by 20 publications

(36 citation statements)

References 28 publications

(18 reference statements)

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“…For those not responding to 5-ASA, the addition of a prednisolone 5 mg suppository in the morning while continuing 5-ASA suppositories at bedtime is worth trying. A novel budesonide suppository was studied in a four-group, prospective, double-blind, double-dummy randomised trial to treat UC proctitis with budesonide 2 mg, budesonide 4 mg, 5-ASA 1 g, or budesonide 2 mg plus 5-ASA 1 g 177. The 8-week study conducted in Germany, Russia and the UK assessed a primary end-point of resolution of clinical symptoms for three consecutive days (score of 0 for rectal bleeding and stool frequency on modified UCDAI).…”

Section: Ulcerative Colitismentioning

confidence: 99%

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Lamb

Kennedy

Raine

et al. 2019

Gut

1,501

1,816

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Ulcerative colitis and Crohn’s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn’s and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn’s disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn’s disease, including patients, their families and friends.

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Section: Ulcerative Colitismentioning

confidence: 99%

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Lamb

Kennedy

Raine

et al. 2019

Gut

1,501

1,816

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“…Budesonide/Beclomethasone/Tacrolimus/Acetarsol suppository might offer benefit for patients with UP refractory to mesalamine suppositories in induction phase. 31,34,40,46 Herbal preparations of Xilei-san 41 and Qingchang suppository 42 might be a considerable choice for patients with UP refractory to mesalamine to induce and maintain remission.…”

Section: Discussionmentioning

confidence: 99%

“…Budesonide is an anti-inflammatory drug. Kruis 31 conducted a double-blind trial in 337 patients with active UP, in order to compare the efficacies and safeties of four different suppositories: 2 mg budesonide, 4 mg budesonide, 1 g mesalamine, and 2 mg budesonide plus 1 g mesalamine. The mean time to resolution of symptoms in the 4 mg budesonide (29.8 days) and combination (29.3 days) groups was similar with that of 1 g mesalamine treatment (29.2 days).…”

Section: Budesonidementioning

confidence: 99%

“…Figure 1.Mesalamine suppository 1 g QD is recommended as the first-line choice to induce and maintain remission, 1,4-6 with an efficacy above 80% 1 in induction phase. Budesonide/Beclomethasone/Tacrolimus/Acetarsol suppository might offer benefit for patients with UP refractory to mesalamine suppositories in induction phase 31,34,40,46. Herbal preparations of Xilei-san41 and Qingchang suppository42 might be a considerable choice for patients with UP refractory to mesalamine to induce and maintain remission.…”

mentioning

confidence: 99%

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Suppository treatment in ulcerative proctitis

Shao

Gao

et al. 2021

Eur J Inflamm

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Ulcerative proctitis (UP) is a common form of ulcerative colitis (UC), the number of patients with UP is increasing. Suppository treatment containing mesalamine is usually the first-line choice for mild to moderate UP, here, we review the publications on mesalamine suppository in UP, to better understand its dosage, duration of therapy and adverse events in both induction and maintenance phases. We also review articles on budesonide, beclomethasone, tacrolimus, herbal medicine and acetarsol suppositories in UP, to present therapeutic strategies for patients with UP refractory to mesalamine suppository.

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“…Although comparative studies historically showed that topical corticosteroids are less effective than topical mesalamine when treating active ulcerative colitis [3], some studies showed similar efficacy between rectal budesonide and rectal 5-ASA [4,5]. As such, given the theoretical superior anti-inflammatory potency of corticosteroid molecules, it is plausible that there may be room for improvement through optimization of their efficacy.…”

mentioning

confidence: 99%