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01-06-2018 | Letter to the Editor

A proposed treatment algorithm for mild to moderate ulcerative colitis—with an emphasis on budesonide foam and mucosal healing

Authors: Juris Pokrotnieks, Stanislav Sitkin

Published in: Journal of Gastroenterology | Issue 6/2018

Excerpt

We read with great interest the paper recently published by Naganuma et al. [1] on the budesonide foam in mild to moderate ulcerative colitis (UC). Indeed, second-generation corticosteroids, such as budesonide, can become a reliable “intermediate layer” between mesalazine and systemic corticosteroids in the UC treatment pyramid. In this regard, we would like to supplement the current treatment algorithm considering data from rectal budesonide studies [1‐6]. …

Naganuma M, Aoyama N, Tada T, et al. Complete mucosal healing of distal lesions induced by twice-daily budesonide 2-mg foam promoted clinical remission of mild-to-moderate ulcerative colitis with distal active inflammation: double-blind, randomized study. J Gastroenterol. 2018;53(4):494–506. https://doi.org/10.1007/s00535-017-1376-4.CrossRefPubMed

Bar-Meir S, Fidder HH, Faszczyk M, et al. Budesonide foam vs. hydrocortisone acetate foam in the treatment of active ulcerative proctosigmoiditis. Dis Colon Rectum. 2003;46(7):929–36.CrossRefPubMed

Gross V, Bar-Meir S, Lavy A, et al. Budesonide foam versus budesonide enema in active ulcerative proctitis and proctosigmoiditis. Aliment Pharmacol Ther. 2006;23:303–12.CrossRefPubMed

Sandborn WJ, Bosworth B, Zakko S, et al. Budesonide foam induces remission in patients with mild to moderate ulcerative proctitis and ulcerative proctosigmoiditis. Gastroenterology. 2015;148(4):740–50.e2.CrossRef

Bosworth BP, Sandborn WJ, Rubin DT, Harper JR. Baseline oral 5-ASA use and efficacy and safety of budesonide foam in patients with ulcerative proctitis and ulcerative proctosigmoiditis: analysis of 2 phase 3 studies. Inflamm Bowel Dis. 2016;22:1881–6.CrossRefPubMedPubMedCentral

Naganuma M, Aoyama N, Suzuki Y, et al. Twice-daily budesonide 2-mg foam induces complete mucosal healing in patients with distal ulcerative colitis. J Crohns Colitis. 2016;10(7):828–36.CrossRefPubMed

Shah SC, Colombel JF, Sands BE, Narula N. Mucosal healing is associated with improved long-term outcomes of patients with ulcerative colitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2016;14(9):1245–55.e8.

Title: A proposed treatment algorithm for mild to moderate ulcerative colitis—with an emphasis on budesonide foam and mucosal healing
Authors: Juris Pokrotnieks
Stanislav Sitkin
Publication date: 01-06-2018
Publisher: Springer Japan
Published in: Journal of Gastroenterology / Issue 6/2018
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI: https://doi.org/10.1007/s00535-018-1458-y

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