Comparison of Beclomethasone Dipropionate and Prednisolone 21-Phosphate Enemas in the Treatment of Ulcerative Proctitis

Heide, H. van der; Brandt-Grädel, V van den; Tytgat, G. N. J.; Endert, E.; Wiltink, E. H. H.; Schipper, Maria; Dekker, W.

doi:10.1097/00004836-198804000-00013

Cited by 61 publications

(30 citation statements)

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“…Two studies, one in patients with distal ulcerative colitis and one in patients with more extensive ulcerative colitis, suggested that topical administration of BDP is as effective as a prednisolone sodium enema and does not affect the hypothalamic-pituitary-adrenal axis function [Mulder et al 1989;Campieri et al 1998]. On the contrary, another trial in patients with ulcerative proctitis suggested that a BDP enema was less effective than prednisolone 21-phosphate enema in ulcerative proctitis (Table 2) [ Van der Heide et al 1988]. Finally, three studies compared the efficacy of BDP, mesalamine and a combination of both drugs: one investigated topical mesalamine and a BDP enema [Mulder et al 1996], one investigated oral, controlled-release BDP with mesalamine [Rizzello et al 2002], and another compared topical BDP (36.7%) and topical mesalamine (29.2%) in 217 patients with distal active ulcerative colitis and demonstrated similar clinical remission rates between the two treatments [Gionchetti et al 2005].…”

Section: Efficacy In Ulcerative Colitismentioning

confidence: 99%

Glucocorticosteroids in the treatment of inflammatory bowel disease and approaches to minimizing systemic activity

Prantera

Marconi

2013

Therap Adv Gastroenterol

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Inflammatory bowel diseases (IBDs) are a group of inflammatory conditions characterized by chronic, uncontrolled inflammation of the gastrointestinal tract. Reported prevalence is high in the United States and northern Europe, while the incidence varies greatly across the rest of Europe. Glucocorticosteroids are the standard treatment for IBD, but due to adverse events their use can be limited. However, new formulations of glucocorticosteroids have been developed to reduce systemic activation. The aim of this review was to assess and summarize the efficacy and safety of new formulations of glucocorticosteroids. A MEDLINE search identified publications focused on new formulations of nonsystemic steroidbased drugs for IBD and benefits and limitations of each of the new glucocorticosteroid formulations were identified. Budesonide has good efficacy and is an established treatment for Crohn's disease; it has been shown to be beneficial for the induction of remission in these patients, although it is not recommended for the maintenance of induced remission. Glucocorticosteroids are not recommended for the maintenance of remission in patients with IBD. However, a recent study suggested that beclomethasone dipropionate may be effective for prolonged treatment in patients in the postacute phase of Crohn's disease who were treated with a short course of systemic steroids. The efficacy of fluticasone propionate and prednisolone metasulphobenzoate in IBD is not well established given the small number of patients enrolled in the few published clinical trials. While the tolerability of these glucocorticosteroids is favourable, more research comparing these new agents with traditional systemic glucocorticosteroids is warranted.

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Section: Efficacy In Ulcerative Colitismentioning

confidence: 99%

Glucocorticosteroids in the treatment of inflammatory bowel disease and approaches to minimizing systemic activity

Prantera

Marconi

2013

Therap Adv Gastroenterol

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“…In patients with UC, BDP enemas have a similar efficacy to mesalazine and other steroid enemas in inducing remission of the disease [50,51,52,53,54,55,56], with a superiority of a combination of BDP and mesalazine enemas over single-agent therapy [57]. Oral BDP is effective in improving clinical, endoscopic and biopsy scores in patients with mild-to-moderate left-sided and extensive UC [58,59,60,61,62].…”

Section: Resultsmentioning

confidence: 99%

Second-Generation Corticosteroids for the Treatment of Crohn’s Disease and Ulcerative Colitis: More Effective and Less Side Effects?

Cassan¹,

Fiorino²,

Danese³

2012

Dig Dis

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Background/Aims: Systemic corticosteroids are highly effective at inducing clinical remission in cases of acute exacerbation of Crohn’s disease (CD) and ulcerative colitis (UC); however, their use is limited by their frequent and sometimes severe side effects. Thus, a second generation of corticosteroids with less systemic effects has been developed. This review analyzed all of the studies on the new formulations of steroids with limited absorption (budesonide, budesonide MMX®, beclomethasone dipropionate and erythrocyte-mediated delivery of dexamethasone) in patients with CD and UC. Methods: All relevant articles published in English between September 1960 and April 2011 were reviewed. Results: Budesonide is superior to placebo, and as effective as systemic corticosteroids in inducing clinical remission in patients with ileo-colonic CD, but evidence of mucosal healing is limited. When administered as an MMX formula, budesonide can also effectively induce clinical remission in patients with UC, but budesonide alone is not effective in maintaining clinical remission in CD or UC. Beclomethasone dipropionate seems to be effective in patients with mild-to-moderate left-sided and extensive UC, while data on erythrocyte-mediated delivery of dexamethasone are encouraging but still limited. The safety profile for all these products is good but more studies are needed. Conclusion: Steroids remain the mainstay for the induction of clinical remission in cases of acute relapse of both CD and UC. Second-generation corticosteroids are an interesting alternative, with the advantage of high topical activity, less systemic toxicity and limited side effects.

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“…The investigators did not observe the rapid improvement seen with PP for BDP [3]. However, the same investigators found equal beneficial effects for 2 and 3 mg BDP enemas, respectively, in comparison with 30 mg PP [4]..…”

Section: Introductionmentioning

confidence: 89%

Formulation and stability of a beclomethasone dipropionate enema

Stolk

Gerrits

Wiltink

et al. 1989

Pharmaceutisch Weekblad Scientific Edition

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A beclomethasone dipropionate (BDP) enema and a BDP/mesalazine combination enema (containing 2 mg BDP and 1 g mesalazine and 2 mg BDP, respectively per 40 ml) were formulated. BDP and mesalazine were suspended in a carbomer-water gel. No degradation of BDP was measured during the storage period of the BDP enema (4 weeks at 20 degrees C) and of the BDP/mesalazine enema (44 days at 4 degrees C, 20 degrees C and 37 degrees C, respectively). Progressive darkening of colour occurred for the BDP/mesalazine enema during storage at 20 degrees C and at 37 degrees C, probably induced by mesalazine degradation products. Only very slight colouring was observed at 4 degrees C. Hardly any precipitation of BDP and mesalazine was seen during the storage period and the enemas could easily be resuspended.

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Comparison of Beclomethasone Dipropionate and Prednisolone 21-Phosphate Enemas in the Treatment of Ulcerative Proctitis

Cited by 61 publications

References 0 publications

Glucocorticosteroids in the treatment of inflammatory bowel disease and approaches to minimizing systemic activity

Glucocorticosteroids in the treatment of inflammatory bowel disease and approaches to minimizing systemic activity

Second-Generation Corticosteroids for the Treatment of Crohn’s Disease and Ulcerative Colitis: More Effective and Less Side Effects?

Formulation and stability of a beclomethasone dipropionate enema

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