Oral budesonide is as effective as oral prednisolone in active Crohn's disease

Florin, T (1997) Oral budesonide is as effective as oral prednisolone in active Crohn's disease. Gut, 41 2: 209-214.

Author Florin, T
Title Oral budesonide is as effective as oral prednisolone in active Crohn's disease
Journal name Gut   Check publisher's open access policy
ISSN 0017-5749
Publication date 1997-01-01
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 41
Issue 2
Start page 209
End page 214
Total pages 6
Language eng
Abstract Background-The use of corticosteroids in active Crohn's disease often becomes limited by side effects. Budesonide is a potent corticosteroid with low systemic bioavailability due to an extensive first pass liver metabolism. Aims-To compare the efficacy and safety of two dosage regimens of budesonide and prednisolone in patients with active Crohn's disease affecting the ileum and/or the ascending colon. Patients and methods-One hundred and seventy eight patients were randomised to receive budesonide controlled ileal release (CIR) capsules 9 mg once daily or 4.5 mg twice daily, or prednisolone tablets 40 mg once daily. The treatment period was 12 weeks. The primary efficacy variable was clinical remission, defined as a Crohn's Disease Activity Index (CDAI) of 150 or less. Results-After eight weeks of treatment, remission occurred in 60% of patients receiving budesonide once daily or prednisolone and in 42% of those receiving budesonide twice daily (p=0.062). The presence of glucocorticoid associated side effects was similar in all groups; however, moon face was more common in the prednisolone group (p=0.0005). The highest frequency of impaired adrenal function, as measured by a short ACTH test, was found in the prednisolone group (p=0.0023). Conclusions-Budesonide CIR, administered at 9 mg once daily or 4.5 mg twice daily, is comparable to prednisolone in inducing remission in active Crohn's disease. The single dose administration is as promptly effective as prednisolone and represents a simpler and safer therapeutic approach, with a considerable reduction in side effects.
Keyword Gastroenterology & Hepatology
Adrenal Function
Glucocorticoid Associated Side Effects
Inflammatory Bowel-disease
Distal Ulcerative-colitis
Release Cir Capsules
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown
Additional Notes Authors of this document: Campieri, M; Ferguson, A; Doe, W; Persson, T; Nilsson, LG; Malchow, H; Prantera, C; Mani, V; OMorain, C; Selby, W; Pallone, F; diPietralata, MM; Sjodahl, R; Florin, T; Smith, P; Bianchi, P; Lofberg, R; Rutgeerts, P; Smallwood, R; Lamers, HW; TasmanJones, C; Hunter, JO; Hodgson, H; Danielsson, A; Lee, FI; Piacitelli, G; Giovanni, S; Ellis, A; Weir, DG.

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 233 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 14 Aug 2007, 02:55:36 EST