2020
DOI: 10.1111/apt.15648
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Long‐term oral budesonide treatment and risk of osteoporotic fractures in patients with microscopic colitis

Abstract: Summary Background Due to a substantial first‐pass metabolism of oral budesonide, systemic bioavailability is low compared to other oral corticosteroids, thereby possibly avoiding adverse effects of systemic corticosteroid use. Aim To determine whether use of oral budesonide is associated with osteoporotic fractures in patients with microscopic colitis (MC). Methods Applying data from the Danish nationwide health registries, we conducted a case‐control study nested within a cohort of patients with MC from 2004… Show more

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Cited by 16 publications
(10 citation statements)
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“…The markers of bone formation pro‐N‐terminal peptide procollagen type 1 and bone alkaline phosphatase were lower in patients with MC than in controls, suggesting an osteoblast dysfunction due to the systemic effect of budesonide or to the disease itself. In a recent case‐control study, 301 there was no increase in osteoporotic fractures in general, but a modest isolated effect of budesonide on the risk of spinal fractures was observed, mainly in younger patients.…”
Section: Clinical Responsementioning
confidence: 92%
“…The markers of bone formation pro‐N‐terminal peptide procollagen type 1 and bone alkaline phosphatase were lower in patients with MC than in controls, suggesting an osteoblast dysfunction due to the systemic effect of budesonide or to the disease itself. In a recent case‐control study, 301 there was no increase in osteoporotic fractures in general, but a modest isolated effect of budesonide on the risk of spinal fractures was observed, mainly in younger patients.…”
Section: Clinical Responsementioning
confidence: 92%
“…MC occurs frequently in older patients with a female predominance, both known risk factors for metabolic bone disease. It is possible that the incidence of osteopenia/osteoporosis seen in our patients may be in part attributed to these factors, rather than budesonide use alone, although studies have demonstrated the risk of osteoporosis in MC is not increased (22–25). Similarly, the incidence of ophthalmologic diseases, such as cataracts, seen in our population may also be in part attributed to increasing age (26,27).…”
Section: Discussionmentioning
confidence: 90%
“…First, budesonide has quite a low systemic bioavailability (10%). 2,3 Therefore, budesonide was used topically by the work of compounding pharmacies in this study, as Nagami et al 4 did. Triamcinolone, also of low systemic bioavailability, 5 is usually administered by locoregional injection.…”
Section: Impact Of Topical Budesonide On Prevention Of Esophageal Stricture After Mucosal Resectionmentioning
confidence: 91%
“…We would like to thank Dr Wu and colleagues 1 for their interest in our study. 2 To their questions:…”
Section: Responsementioning
confidence: 99%