Oral locally active steroids in inflammatory bowel disease.
IBD is a chronic and relapsing inflammatory disorder of the gut that demands long-lasting treatment targeting both flare-up periods and maintenance of remission. Oral systemic steroids have been used to induce remission in patients with active IBD for over 50 years due to their potent anti-inflammatory effects. The efficacy of systemic steroids in this setting has been largely demonstrated. However, the wide range of adverse events associated with these drugs has prompted the development of equally effective but less toxic steroid compounds. Currently, topically acting oral steroids are an important therapeutic option for Crohn's disease, ulcerative colitis and microscopic colitis, being oral budesonide and oral beclomethasone established elements of the IBD armamentarium. At present, oral budesonide is the first-line therapy to induce remission in microscopic colitis and mild to moderate ileocaecal CD patients and oral beclomethasone is effective treating mild to moderate UC patients with left-sided or extensive disease. This review aims at evaluating the current role of these compounds in IBD clinical practice.
Chair for Biofunctionality, Research Center for Nutition and Food Science (ZIEL), Technische Universität München, Freising, Germany.
Tiago
T
Nunes
Manuel
M
Barreiro-de Acosta
Ignácio
I
Marin-Jiménez
Pilar
P
Nos
Miquel
M
Sans
D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001507:Beclomethasone / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D046728:Colitis, Microscopic / Q000188:drug therapy; D003093:Colitis, Ulcerative / Q000188:drug therapy; D003424:Crohn Disease / Q000188:drug therapy; D006801:Humans; D060828:Induction Chemotherapy; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D060046:Maintenance Chemotherapy
D000893:Anti-Inflammatory Agents; D019819:Budesonide; D001507:Beclomethasone