pulmicort and Ileal-Diseases

Topics: Adrenal Cortex Hormones; Anastomosis, Surgical; Anti-Inflammatory Agents; Antibodies, Monoclonal; Budesonide; Colon; Constriction, Pathologic; Crohn Disease; Dilatation; Endoscopy; Gastrointestinal Agents; Glucocorticoids; Humans; Ileal Diseases; Ileum; Infliximab; Intestinal Obstruction; Magnetic Resonance Imaging; Prosthesis Implantation; Randomized Controlled Trials as Topic; Recurrence; Risk Factors; Time Factors

The nonsystemic steroid budesonide has been used to treat active ileocecal and ileocolonic Crohn's disease (CD). This study investigated the optimal budesonide dose using a pH-dependent release formulation. The goal of treatment was the remission of CD (CDAI <150) within 6 weeks of treatment.. The study was of randomized, double-blind, dose-finding design. Patients with active CD ileocolitis without steroid pretreatment were treated with 3x2 mg ( n=39), 3x3 mg ( n=33), or 3x6 mg ( n=32) oral pH-modified released budesonide daily.. The remission rates after 6 weeks were 36% with 3x2 mg, 55% with 3x3 mg, and 66% with 3x6 mg. Significantly more patients were in remission while treated with 3x6 mg than with 3x2 mg budesonide/day. Subgroup analyses revealed that patients with high disease activity (CDAI >/= 300) or ileocolonic disease with disease manifestation distal to the transverse colon responded better to the highest budesonide dose.. Oral pH-modified released budesonide shows a dose-dependent effectiveness in patients with active ileocolonic CD. In the majority of patients 9 mg budesonide per day is sufficient. However, in patients with highly active disease or ileal disease with distal colonic manifestation higher doses of budesonide could increase the therapeutic response

Topics: Adult; Anti-Inflammatory Agents; Budesonide; Colonic Diseases; Crohn Disease; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Female; Humans; Hydrocortisone; Ileal Diseases; Male; Treatment Outcome

Topics: Adult; Ascites; Biopsy; Budesonide; Colonoscopy; Diarrhea; Eosinophilic Esophagitis; Esophagoscopy; Glucocorticoids; Humans; Hypereosinophilic Syndrome; Ileal Diseases; Male; Remission Induction; Tomography, X-Ray Computed; Treatment Outcome

Budesonide (BUD) is being used in pediatric Crohn disease (CD) because it is believed to have the potential to reduce corticosteroid-related toxicity; however, few data are available describing its use. The aim of the present study was to describe BUD use in an inception cohort of pediatric patients with CD.. Data were derived from the prospective Pediatric IBD Collaborative Research Group Registry established in 2002 in North America. Use of BUD in children with CD was examined.. BUD was used in 119 of 932 (13%) of children with newly diagnosed CD, with 56 of 119 (47%) starting BUD ≤ 30 days of diagnosis (26/56 with ileum and/or ascending colon [IAC] disease). BUD was used as monotherapy (9%), in combination with 5-aminosalicylates (77%), or in combination with immunomodulators (43%). Forty-three percent (24/56) went on to receive conventional corticosteroid at some point following their first BUD course. For the 63 of 119 (53%) who started BUD beyond the diagnosis period, 51 of 63 (81%) also received prednisone, with BUD used as a means of weaning from prednisone in 17 of 63 (27%). Patients with IAC disease who received BUD ≤ 30 days of diagnosis were just as likely to have received conventional corticosteroids by 1 year as were those who did not receive BUD ≤ 30 days of diagnosis. Two-thirds (77/119) of patients received BUD for ≤ 6 months.. BUD is being used among pediatric patients newly diagnosed as having CD, although the majority does not have disease limited to the IAC. BUD monotherapy was rare, and further data are required to better define the role of BUD in the treatment of pediatric CD.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Budesonide; Child; Colon; Colonic Diseases; Crohn Disease; Drug Therapy, Combination; Female; Humans; Ileal Diseases; Ileum; Immunologic Factors; Male; Mesalamine; Prednisone; Young Adult