What is the role of budesonide in the treatment of inflammatory bowel disease (IBD)?

Updated: Oct 17, 2017
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Answer

Budesonide (Entocort EC), a synthetic corticosteroid, is available for Crohn disease with ileal or ileocecal involvement. [70] Budesonide has extensive first-pass metabolism, which limits systemic adverse effects. [90] However, some absorption occurs over a prolonged period of exposure. Budesonide is also less effective than other standard glucocorticosteroids for the treatment of ileal Crohn disease and has not demonstrated efficacy in maintaining therapy beyond 12 months. [89]

According to the American Gastroenterological Association (AGA) guidelines, ileal-release preparations of budesonide are indicated for the treatment of patients with mild to moderate ileal and right-sided colonic Crohn disease. [90] These preparations have not been demonstrated to be effective in patients with ulcerative colitis, but clinical trials in this setting are under way. [90]


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