title: Budesonide induction and maintenance therapy for Crohn's disease during pregnancy.
abstract: BACKGROUND
  There is no standard approach for the medical management of Crohn's disease (CD) during pregnancy and there is limited data regarding safety and efficacy of the treatments. Budesonide (Entocort EC, AstraZeneca) is an enteric coated locally acting glucocorticoid preparation whose pH- and time-dependent coating enables its release into the ileum and ascending colon for the treatment of mild to moderate Crohn's disease. There is no available data on the safety of using oral budesonide in pregnant patients.
  
  
  METHODS
  We reviewed our Inflammatory Bowel Disease (IBD) center database to identify patients with CD who received treatment with budesonide for induction and/or maintenance of remission during pregnancy and describe the maternal and fetal outcomes in a series of eight mothers and their babies.
  
  
  RESULTS
  The mean age of the patients was 27.7 years. All patients had small bowel involvement with their CD. The disease pattern was stricturing in 6 patients, fistulizing in 1 and inflammatory in 1 patient. Budesonide was used at the 6 mg/day dose in 6 patients and 9 mg/day dose in 2 patients. The average treatment duration ranges from 1-8 months. There were no cases of maternal adrenal suppression, glucose intolerance, ocular side effects, hypertension or fetal congenital abnormalities.
  
  
  CONCLUSIONS
  Budesonide may be a safe option for treatment of CD during pregnancy.
authors.affiliation: Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
authors.forename: Dawn B
authors.initials: DB
authors.lastname: Beaulieu
authors.forename: Ashwin N
authors.initials: AN
authors.lastname: Ananthakrishnan
authors.forename: Mazen
authors.initials: M
authors.lastname: Issa
authors.forename: Lydia
authors.initials: L
authors.lastname: Rosenbaum
authors.forename: Sue
authors.initials: S
authors.lastname: Skaros
authors.forename: Julianne R
authors.initials: JR
authors.lastname: Newcomer
authors.forename: Randall S
authors.initials: RS
authors.lastname: Kuhlmann
authors.forename: Mary F
authors.initials: MF
authors.lastname: Otterson
authors.forename: Jeanne
authors.initials: J
authors.lastname: Emmons
authors.forename: Josh
authors.initials: J
authors.lastname: Knox
authors.forename: David G
authors.initials: DG
authors.lastname: Binion
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D019819:Budesonide