Enteric-Release Budesonide May Be Useful in the Management of Non-Responsive Celiac Disease
| Autor: | Jocelyn A. Silvester, Alessio Fasano, Amelie Therrien, Ciaran P. Kelly, Daniel A. Leffler, Maureen M. Leonard |
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| Rok vydání: | 2020 |
| Předmět: |
Budesonide
chemistry.chemical_classification medicine.medical_specialty Abdominal pain Physiology business.industry Gastroenterology Disease Hepatology Gluten 03 medical and health sciences Diarrhea 0302 clinical medicine Refractory chemistry 030220 oncology & carcinogenesis Internal medicine Medicine 030211 gastroenterology & hepatology Villous atrophy medicine.symptom business medicine.drug |
| Zdroj: | Digestive Diseases and Sciences. 66:1989-1997 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | Non-responsive celiac disease (NRCD) has many aetiologies, including gluten exposure. Budesonide may be used for refractory celiac disease (RCD) and celiac crisis. We reviewed the effectiveness of budesonide to induce clinical and histologic response in NRCD with villous atrophy (VA). Case series of adult cases with NRCD and VA prescribed budesonide at two celiac centers. Clinical variables and mucosal recovery (i.e., normal villous architecture within 1 year of treatment) were evaluated. Forty-two cases [77% female, median age 45.0 (IQR 28.3–60.0) years] were included. Most common symptoms were diarrhea (64%) and abdominal pain (62%). Budesonide was initiated at 9 mg (83%) for a median duration of 16.0 weeks (IQR 6.8–25.0 weeks). In total, 57% exhibited a clinical response, positively associated with diarrhea (adjusted OR 6.08 95% CI 1.04–35.47) and negatively with fatigue (adjusted OR 0.18 95% CI 0.03–0.98). Clinical response was higher among those with dietitian counseling prior to budesonide (n = 29, 70 vs. 23%, p |
| Databáze: | OpenAIRE |
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