US EPA

4115549 

Journal Article 

LACK OF ADRENAL-GLAND SUPPRESSION WITH BUDESONIDE ENEMA IN ACTIVE DISTAL ULCERATIVE-COLITIS - A PREDNISOLONE-CONTROLLED 8-WEEK STUDY 

Thomsen, OO; Andersen, T; Langholz, E; Lofberg, R; Malchowmoller, A; Matzen, P; Nordstrom, H; Persson, T 

1994 

Yes 

European Journal of Gastroenterology and Hepatology
ISSN: 0954-691X
EISSN: 1473-5687 

6 

6 

507-511 

10.1097/00042737-199406000-00010 

WOS:A1994NN64400010 

Objective: To compare the effect of two glucocorticosteroid enemas, budesonide and prednisolone, on adrenal gland function in patients with active distal ulcerative colitis.



Design: A randomized, controlled, investigator-blind study.



Setting: A multicentre study among outpatients from three Danish gastroenterology departments participating in a Scandinavian multicentre study.



Patients: The study included 26 patients with active distal ulcerative colitis, with a median disease duration of 6.5 years and a median duration of the current disease exacerbation of 26 days.



Intervention: Bedtime retention enemas, budesonide (2 mg/100 ml), or prednisolone disodium phosphate (25 mg/100 ml) were administered daily for up to 8 weeks. Adrenocorticotropic hormone (ACTH) tests were performed at entry and after 4 and 8 weeks of treatment.



Results: Baseline plasma cortisol values were significantly suppressed after 4 and 8 weeks of prednisolone treatment, but remained unchanged during budesonide treatment. In the prednisolone group at weeks 4 and 8, plasma cortisol levels were below 500 nmol/l 30 min after ACTH injection in eight out of 14 and four out of nine patients, respectively. By contrast, the ACTH tests were normal in the budesonide-treated patients.



Conclusion: Budesonide enema is as effective as prednisolone enema in the treatment of active distal ulcerative colitis and does not suppress adrenal gland function. 

ADRENOCORTICOTROPIC HORMONE; ADRENAL GLAND FUNCTION; BUDESONIDE; INFLAMMATORY BOWEL DISEASE; PREDNISOLONE; STEROID ENEMAS; ULCERATIVE COLITIS