Collagenous colitis: Requirement for high-dose budesonide as maintenance treatment
| Autor: | María José Casanova, Javier P. Gisbert, M Piqueras, Virginia Robles, Yolanda Arguedas, Fernando Fernández-Bañares, Ángeles Pérez-Aisa, Alexandra Ruiz-Cerulla, David Busquets, Danila Guagnozzi, Alfredo J. Lucendo, Luis Fernández-Salazar |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Budesonide medicine.medical_specialty Multivariate analysis Colitis Collagenous Anti-Inflammatory Agents Azathioprine Logistic regression Gastroenterology Maintenance Chemotherapy 03 medical and health sciences 0302 clinical medicine Maintenance therapy Recurrence Risk Factors Internal medicine medicine Humans 030212 general & internal medicine Retrospective Studies Dose-Response Relationship Drug Hepatology Collagenous colitis Mercaptopurine business.industry Anti-Inflammatory Agents Non-Steroidal Remission Induction Retrospective cohort study Middle Aged medicine.disease Logistic Models Spain Multivariate Analysis Female 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | Digestive and Liver Disease. 49:973-977 |
| ISSN: | 1590-8658 |
| Popis: | Background Controlled studies show high efficacy of budesonide in inducing short-term clinical remission in collagenous colitis (CC), but relapses are common after its withdrawal. Aim To evaluate the need for high-dose budesonide (≥6 mg/d) to maintain clinical remission in CC. Methods Analysis of a multicentre retrospective cohort of 75 patients with CC (62.3 ± 1.5 years; 85% women) treated with budesonide in a clinical practice setting between 2013 and 2015. Frequency of budesonide (9 mg/d) refractoriness and safety, and the need for high-dose budesonide to maintain clinical remission, were evaluated. Drugs used as budesonide-sparing, including azathioprine and mercaptopurine, were recorded. Logistic regression analysis was performed to evaluate the risk factors associated with the need for high-dose budesonide (≥6 mg/d) to maintain clinical remission. Results Budesonide induced clinical remission in 92% of patients, with good tolerance. Fourteen of 68 patients (21%; 95% CI, 13–32%) needed high-dose budesonide to maintain remission. Only intake of NSAIDs at diagnosis (OR, 8.6; 95% CI, 1.6–44) was associated with the need for high-dose budesonide in the multivariate analysis. Treatment with thiopurines was effective in 5 out of 6 patients (83%; 95% CI, 44–97%), allowing for withdrawal from or a dose decrease of budesonide. Conclusions One fifth of CC patients, especially those with NSAID intake at diagnosis, require high-dose budesonide (≥6 mg/d) to maintain clinical remission. In this setting, thiopurines might be effective as budesonide-sparing drugs. |
| Databáze: | OpenAIRE |
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