Budesonide Use in Pediatric Crohn Disease
Journal of Pediatric Gastroenterology and Nutrition, 08/03/2012
Otley A et al. – Budesonide (BUD) is being used among pediatric patients newly diagnosed as having Crohn disease (CD), although the majority does not have disease limited to the ileum and/or ascending colon [IAC]. BUD monotherapy was rare, and further data are required to better define the role of BUD in the treatment of pediatric CD.Methods
- Data were derived from the prospective Pediatric IBD Collaborative Research Group Registry established in 2002 in North America.
- Use of BUD in children with CD was examined.
- BUD was used in 119 of 932 (13%) of children with newly diagnosed CD, with 56 of 119 (47%) starting BUD ≤30 days of diagnosis (26/56 with ileum and/or ascending colon [IAC] disease).
- BUD was used as monotherapy (9%), in combination with 5-aminosalicylates (77%), or in combination with immunomodulators (43%).
- Forty-three percent (24/56) went on to receive conventional corticosteroid at some point following their first BUD course.
- For the 63 of 119 (53%) who started BUD beyond the diagnosis period, 51 of 63 (81%) also received prednisone, with BUD used as a means of weaning from prednisone in 17 of 63 (27%).
- Patients with IAC disease who received BUD ≤30 days of diagnosis were just as likely to have received conventional corticosteroids by 1 year as were those who did not receive BUD ≤30 days of diagnosis.
- Two-thirds (77/119) of patients received BUD for ≤6 months.