title: Budesonide use in pediatric Crohn disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Pediatric Gastroenterology, IWK Health Centre, Halifax, Canada. arotley@dal.ca
authors.forename: Anthony
authors.initials: A
authors.lastname: Otley
authors.forename: Neal
authors.initials: N
authors.lastname: LeLeiko
authors.forename: Christine
authors.initials: C
authors.lastname: Langton
authors.forename: Trudy
authors.initials: T
authors.lastname: Lerer
authors.forename: David
authors.initials: D
authors.lastname: Mack
authors.forename: Jonathan
authors.initials: J
authors.lastname: Evans
authors.forename: Marian
authors.initials: M
authors.lastname: Pfefferkorn
authors.forename: Ryan
authors.initials: R
authors.lastname: Carvalho
authors.forename: Joel
authors.initials: J
authors.lastname: Rosh
authors.forename: Anne
authors.initials: A
authors.lastname: Griffiths
authors.forename: Maria
authors.initials: M
authors.lastname: Oliva-Hemker
authors.forename: Marsha
authors.initials: M
authors.lastname: Kay
authors.forename: Athos
authors.initials: A
authors.lastname: Bousvaros
authors.forename: Michael
authors.initials: M
authors.lastname: Stephens
authors.forename: Charles
authors.initials: C
authors.lastname: Samson
authors.forename: Andrew
authors.initials: A
authors.lastname: Grossman
authors.forename: David
authors.initials: D
authors.lastname: Keljo
authors.forename: James
authors.initials: J
authors.lastname: Markowitz
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hyams
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D002648:Child; D003106:Colon; D003108:Colonic Diseases / Q000188:drug therapy; D003424:Crohn Disease / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000188:drug therapy; D007082:Ileum; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D007155:Immunologic Factors; D019804:Mesalamine; D019819:Budesonide; D011241:Prednisone