Early Oral & Topical Anti-inflammatory Therapies for IBD
Budesonide MMX / Ferring Inc. (2016)
Delayed and extended-release tablets are indicated for the induction of remission in patients with active, mild-to-moderate ulcerative colitis.
Oral
9 mg daily for up to 8 weeks.
In patients >30 kg, BDP is 5 mg once daily for 4 weeks and budesonide MMX 9 mg for 8 weeks.
Dosing for children <30 kg has not been established.
There is no evidence to support tapering. While abrupt discontinuation has been practiced in RCT’s, alternate day tapering over 2-4 weeks has been proposed by some.12
RCTs: randomized clinical trials, IV: intravenous, BDP: beclomethasone dipropionate
For more detailed information regarding side effects, please refer to the appropriate product monograph.
• Increased risk of infection
• Hypertension
• Diabetes mellitus
• Osteoporosis
• Peptic ulcer
• Glaucoma or cataracts
• Cushing syndrome
• Mood changes
IBD: inflammatory bowel disease
Safety and efficacy in children have not been established. No data available.
Turner D. et al. suggest12:
May be considered for left-sided colitis with mild disease refractory to 5-ASA before oral prednisone.
There is insufficient and adequate data in patients >65. Caution should be used due to potential decreased hepatic, renal, or cardiac function, or due to concomitant disease or therapies.
Recommendations14:
May be preferred in older patients with left-sided ulcerative colitis.
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IBD: inflammatory bowel disease, 5-ASA: 5-aminosalicylic acid, ECCO: European Crohn’s and Colitis Organization, EEN: enteral nutrition