entecort vs. prednisone

[wmonique2]

Hello friends----read on. Results of a new study...


Budesonide more effective, led to less recurrence than prednisone for microscopic colitis
Gentile NM. Am J Gastroenterol. 2013;doi:10.1038/ajg.2012.416.
January 21, 2013
Patients with microscopic colitis treated with budesonide had better outcomes than those who received prednisone in a recent study.

See Also
Non-celiac gluten sensitivity less common than celiac disease ...
Golimumab effectively treats ulcerative colitis in phase 3 study ...
FDA OKs Humira for ulcerative colitis
Researchers performed a retrospective chart review of 80 patients with microscopic colitis (MC) who were treated with corticosteroids. Sixty-three patients were assigned budesonide (median dose 9 mg), with the remaining 17 receiving prednisone (median dose 25 mg). Response to treatment was defined as either resolution (complete response) or at least 50% improvement (partial response) to diarrhea symptoms.


Darrell S. Pardi
“Steroids are commonly used for this condition, and we wanted to see if our clinical experience paralleled that which has been reported in randomized clinical trials,” researcher Darrell S. Pardi, MD, MS, associate dean for medicine-pediatrics, at Mayo School of Graduate Medical Education in Rochester, Minn., told Healio.com. “In addition, budesonide is used much more commonly than prednisone due to fewer side effects, but it is more expensive, so we wanted to see if that extra cost is worth it.”

Overall, complete response occurred in 75.6% of cases; 20.3% of patients experienced partial response. Among prednisone recipients, 52.9% experienced full response, 41.2% partial and 5.9% no response. In the budesonide group, 82.5% had complete response, 14% partial response and 3.5% no response. Budesonide recipients were significantly more likely to experience complete response (OR=4.18; 95% CI, 1.3-13.5).

A median follow-up of 4 years was conducted for 74 evaluable patients, 71 of whom experienced partial or complete response. Recurrence occurred in 70.4% of these responders and was significantly less common among budesonide recipients (HR=0.38; 95% CI, 0.18-0.85) than prednisone patients. The median time to recurrence also was shorter among prednisone recipients (21 days vs. 63.5 days, P=.02). During 397 person-years of follow-up, maintenance therapy with corticosteroids was necessary in 64.4% of cases for which long-term data were available (73 patients).

“Steroids, particularly budesonide, work very well in microscopic colitis, but the relapse rate is high, and maintenance therapy is often needed,” Pardi said. “Budesonide is at least as good and possibly better than prednisone.”

Monique

[Leah]

Considering how well it worked for me, this doesn't surprise me..... the relapse statement is also so true unless you take care of your diet ( they didn't mention that part!)

Leah

[wmonique2]

Leah,

No, they didn't mention the diet...but if the participants were treated by your run-of-the-mil GI doc, they were probably told to eat everything, which is what happened to me. Entecort worked for me but was a bitch to get off of... I know that some of us are going the prednisone way because of cost....

Monique

[wmonique2]

Leah,

I wanted to ask you a question irrelevant to this topic...I am wondering how are you doing on the anti-histamine. Are you still on it and how do you feel after being so long on it?

I am taking Elavil, which works great except that it packs on the pounds. I am where I want to be and don't want to get any bigger. I was thinking on switching to anti-histamine since it pretty much achieves the same thing. I tried it and I know it works. I was just wondering about taking it for so long...

Thanks,

Monique

[Leah]

Hi Monique. I still take one Claritan every day and I don't see any ill effects. One day down the road, I'll stop taking it and see if I still need them, but for now, I'm doing really well on it :)

Leah

[birdlover3]

I have a question....if you're taking Budesonide, and it is working great does that have anything to do with your food sensitivities? In other words, if a person had food problems, would it be working this well if the person kept eating normally or is there nothing to do with it (med would work fine no matter what)?

[tex]

For a few members here, Entocort (budesonide) is effective enough for them that they can eat anything they want, as long as they are taking the drug. After they stop taking it , they usually relapse.

For most of us, budesonide will help, but in order to achieve complete remission of all symptoms, we have to at least avoid gluten. Some members here have to also avoid dairy, and some members also have to avoid soy. But budesonide will usually effectively mask most other food sensitivities.

For a few of us though, budesonide will only control our symptoms if we also avoid virtually all of our food sensitivities, including most of the minor ones.

IOW, there is an extremely wide range of effectiveness, because each of us has differing thresholds of sensitivities to foods, and drugs affect each of us differently.

Tex