Early Oral & Topical Anti-inflammatory Therapies for IBD
ENEMA budesonide / A registered trademark owned by Tillotts Pharma AG, used under license by Pendopharm, division of Pharmascience Inc (2018)
Induction of remission in patients with mild-to-moderate distal ulcerative colitis (rectum, sigmoid, and descending colon).
Rectal enema
Rectal suspension (enema)
0.02 mg/mL enema given nightly for 4 weeks; if remission not induced may continue for additional 4 weeks.
No pediatric data, provider judgement.
RCTs: randomized clinical trials, IV: intravenous, BDP: beclomethasone dipropionate
For more detailed information regarding side effects, please refer to the appropriate product monograph.
• Hyperglycemia
• Adrenocortical insufficiency
• Acne vulgaris
• Agitation
• Allergic dermatitis
• Mood changes
• Hypertension
• Insomnia
IBD: inflammatory bowel disease
Entocort® safety and effectiveness has not been established and is not recommended.
Turner D. et al. suggest12:
Rectal steroid preparations are useful for patients who are 5-ASA intolerant. Meta-analysis data consistently supports the superiority of rectal mesalamine over rectal steroids.
Second-generation topical steroids have a more favourable safety profile and may be considered before systemic steroids.
Product monograph has no acknowledgement of the older population.
Recommendations14:
Topical corticosteroids may be effective for distal colonic disease but may be poorly tolerated in older patients with limited mobility or weak sphincter tone.
Coming soon
Coming soon
IBD: inflammatory bowel disease, 5-ASA: 5-aminosalicylic acid, ECCO: European Crohn’s and Colitis Organization, EEN: enteral nutrition