Document Detail

Oral budesonide in the treatment of chronic refractory pouchitis.
MedLine Citation:
PMID:  17451569     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pouchitis is the major long-term complication after ileal-pouch nal anastomosis for ulcerative colitis. Ten to 15% of patients develop a chronic pouchitis, either treatment responsive or treatment refractory. AIM: To evaluate the efficacy of oral budesonide in inducing remission and improving quality of life in patients with chronic refractory pouchitis. METHODS: Twenty consecutive patients with active pouchitis, not responding after 1 month of antibiotic treatment were treated with budesonide controlled ileal release 9 mg/day for 8 weeks. Symptomatic, endoscopic and histological evaluations were undertaken before and after treatment according to Pouchitis Disease Activity Index. Remission was defined as a combination of Pouchitis Disease Activity Index clinical score of < or = 2, endoscopic score of < or = 1 and total Pouchitis Disease Activity Index score of < or = 4. The quality of life was assessed with the Inflammatory Bowel Disease Questionnaire. RESULTS: Fifteen of 20 patients (75%) achieved remission. The median total Pouchitis Disease Activity Index scores before and after therapy were, respectively, 14 (range 9-16) and 3 (range 2-10) (P < 0.001). The median Inflammatory Bowel Disease Questionnaire score also significantly improved from 105 (range 77-175) to 180 (range 85-220) (P < 0.001). CONCLUSION: Eight-week treatment with oral budesonide appears effective in inducing remission in patients with active pouchitis refractory to antibiotic treatment in this open-label study.
P Gionchetti; F Rizzello; G Poggioli; F Pierangeli; S Laureti; C Morselli; R Tambasco; C Calabrese; M Campieri
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  25     ISSN:  0269-2813     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-24     Completed Date:  2007-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1231-6     Citation Subset:  IM    
Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy.
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MeSH Terms
Administration, Oral
Anti-Bacterial Agents / therapeutic use
Anti-Infective Agents / administration & dosage*
Budesonide / administration & dosage*
Chronic Disease
Colitis, Ulcerative / surgery
Delayed-Action Preparations
Middle Aged
Patient Compliance
Pouchitis / drug therapy*
Quality of Life / psychology*
Treatment Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Infective Agents; 0/Delayed-Action Preparations; 51333-22-3/Budesonide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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