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Journal of Crohn's and Colitis: 9 (7)

Editor-in-Chief

Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium

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Published on behalf of

Oral locally active steroids in inflammatory bowel disease

Tiago Nunes , Manuel Barreiro-de Acosta , Ignácio Marin-Jiménez , Pilar Nos , Miquel Sans
DOI: http://dx.doi.org/10.1016/j.crohns.2012.06.010 183-191 First published online: 1 April 2013

Abstract

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.

Keywords
  • Budesonide
  • Beclomethasone
  • Steroids
  • Ulcerative colitis
  • Crohn's disease
  • Microscopic colitis
  • Abbreviations
    IBD
    inflammatory bowel disease
    CD
    Crohn's disease
    MC
    microscopic colitis
    UC
    Ulcerative colitis
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