The Annals New | Pharmaco Epidemiology and Therapeutic Risk Management
home help contact us subscription past issues search current issue
QUICK SEARCH:   [advanced]


     

The Annals of Pharmacotherapy: Vol. 37, No. 10, pp. 1457-1464. DOI 10.1345/aph.1D059
© 2003 Harvey Whitney Books Company.
This Article
Right arrow Résumé Freely available
Right arrow Extracto Freely available
Right arrow Full Text
Right arrow PDF
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Articles Ahead of Print
Right arrow [Order Reprint]
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hofer, K. N
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hofer, K. N

FORMULARY FORUM

Oral Budesonide in the Management of Crohn's Disease

Kristi N Hofer, PharmD

Drug Information Specialist, Department of Pharmacy Services, University of Virginia Health System, PO Box 800674, Charlottesville, VA 22908-0674, FAX 434/982-1682, knp2p{at}virginia.edu

Reprints: Kristi N Hofer PharmD

OBJECTIVE: To review the pharmacology, pharmacokinetics, efficacy, and safety of oral budesonide (Entocort EC) in the treatment of mild to moderate Crohn's disease (CD).

DATA SOURCES: The MEDLINE database (1966-December 2002) was searched using the key words budesonide and inflammatory bowel diseases and restricted to the English language. The references from relevant articles were also reviewed for additional citations.

STUDY SELECTION AND DATA EXTRACTION: Articles and abstracts that evaluated oral budesonide for management of CD were considered, with emphasis on randomized, controlled clinical trials.

DATA SYNTHESIS: Budesonide's high potency at the glucocorticoid receptor and extensive first-pass hepatic metabolism result in a topical antiinflammatory effect on intestinal tissue, with minimal systemic glucocorticoid adverse effects. Clinical trials have demonstrated that budesonide is effective in the treatment of patients with mild to moderate CD of the ileum and ascending colon, with efficacy similar to prednisolone and superior to mesalamine. Long-term therapy with budesonide increased the duration of CD remission, but the effect was not sustained up to 1 year. Budesonide failed to prevent postsurgical relapse of CD. Adrenal suppression and glucocorticoid-related adverse effects have been reported at lower rates in patients treated with budesonide compared with prednisolone. Patients prescribed budesonide should be monitored for hepatic dysfunction and potential drug interactions.

CONCLUSIONS: Budesonide is an effective and relatively safe option for treatment of mild to moderate CD of the ileum and ascending colon.

Key Words: budesonide, Crohn's disease, Entocort EC, inflammatory bowel disease

Published Online, August 15, 2003. www.theannals.com, DOI 10.1345/aph.1D059

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-03-029-H01




homecopy help contact us subscription past issues search current issue
Copyright © 2003 by Harvey Whitney Books Company.