Evaluation of oral budesonide for treatment of mild and moderate exacerbations of Crohn's disease in children.
OBJECTIVE
Oral budesonide has been found to be efficacious for mild to moderate Crohn's disease in adults, with equal improvement rates for budesonide and prednisone. We report the results of a retrospective study of budesonide treatment in mild to moderate Crohn's disease in children.


METHODS
Charts of patients treated with budesonide (n = 62) with a pediatric Crohn's Disease Activity Index of 12.5 to 40 were compared with a cohort of 58 age-matched patients treated with prednisone.


RESULTS
Among children treated with budesonide, 48% had remission compared with 77% of the children treated with prednisone (P =.001). Among patients who had failed previous medical therapy with mesalamine, 59% had remission with budesonide (9 mg/day). Remission with prednisone occurred in 73% of children who failed to achieve remission with budesonide. Patients responding to budesonide had significantly milder disease compared with nonresponders who had remission while taking prednisone.


CONCLUSIONS
Budesonide is useful in mild to moderate Crohn's disease in children. It is more effective than mesalamine and antibiotics but less effective than prednisone. Budesonide should be considered for first-line therapy in mild to moderate Crohn's disease.
Levine
Arie
A
Pediatric Gastroenterology Units of the Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Israel.
Broide
Efrat
E
Stein
Michal
M
Bujanover
Yoram
Y
Weizman
Zvi
Z
Dinari
Gabriel
G
Pacht
Avi
A
Branski
David
D
Zahavi
Ilan
I
D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D019819:Budesonide / Q000008:administration & dosage* / Q000494:pharmacology; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids; D006128:Growth / Q000187:drug effects; D006801:Humans; D008297:Male; D011241:Prednisone / Q000494:pharmacology; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D019819:Budesonide; D011241:Prednisone