Serum Prednisolone Levels in Crohn’s Disease and Coeliac Disease following Oral Prednisolone Administration

Abstract

Serum prednisolone levels have been measured following the oral administration of 20 mg prednisolone in 10 normal subjects, in 9 patients with Crohn’s disease and in 6 with coeliac disease. Serum prednisolone levels showed more variation in patients with Crohn’s disease when compared to normal subjects. In those patients with Crohn’s disease who failed to respond to corticosteroid therapy, adequate serum levels of prednisolone were achieved. Patients with coeliac disease had levels similar to normal. Serum protein binding of prednisolone was not significantly different between the groups. We conclude that, even in the presence of mucosal damage, patients with coeliac disease and Crohn’s disease achieve therapeutic serum prednisolone levels.

Bioavailability of Prednisolone in Patients with Intestinal Malabsorption: The Importance of Measuring Serum Protein-Binding

“…Malabsorption of prednisolone cannot be ruled out, since comparative intravenous studies were not performed. However, the normal bioavailability of prednisolone in.the two previous studies (2,3) suggests that malabsorption of prednisolone is not an important cause of the decreased C,,, and AUC,,, in the present celiac disease patients. The differences are best explained by an increased volume of distribution secondary to the hypoalbuminemia and the reduced serum protein-binding found in these patients.…”

Drug absorption in celiac disease

“…Tanner et al 29 measured prednisolone levels in 6 patients with celiac disease, 9 patients with Crohn's disease, and 10 healthy controls. Patients received prednisolone 20 mg following a midnight fast, and blood samples were taken at half-hour intervals for 2 hours and 3, 6, and 8 hours after dose administration.…”

Gibt es Neues in der Standardtherapie der CED?

“…Die Absorption oral zugeführter Glukokortikosteroide (GCS) ist bei Patienten mit CED ähnlich wie bei gesunden Kontrollen [48]. Weiterhin ist von Bedeutung, daß sowohl Schäume als auch Einläufe, rektal appliziert, in der Regel bis zur linken Flexur Wirksamkeit aufweisen.…”