ISSN:
1365-2036
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
To perform a meta-analysis to assess the effectiveness and safety of oral budesonide for inducing remission in active Crohn’s disease and for preventing relapse in Crohn’s disease with medically- or surgically-induced remission.〈section xml:id="abs1-2"〉〈title type="main"〉Methods:All randomized, double-blind controlled trials involving oral budesonide therapy in Crohn’s disease were retrieved from a Medline search, reviews articles or their bibliographies. Of 83 articles retrieved, 12 met the inclusion criteria. Data extraction was performed by three independent observers and scoring disagreements were resolved by consensus.〈section xml:id="abs1-3"〉〈title type="main"〉Results:Six trials tested budesonide in active disease and six in quiescent disease. Budesonide was less effective than conventional corticosteroids for inducing remission of active Crohn’s disease (pooled rate difference, RD –8.5%; 95% CI: –16.4 to –0.7%; P=0.02), but corticosteroid-related adverse events were reduced (RD –22.4%; 95% CI: –32 to –12.8%; P 〈 0.001). In quiescent Crohn’s disease, budesonide was as effective as placebo for preventing relapse in medically induced remission (RD –0.8%; 95% CI: –9.9 to 8.3%; P=0.42) and endoscopic recurrence in surgically induced remission (RD –3.5%; 95% CI: –16.9 to 9.8%; P=0.30). In the long term treatment, budesonide had an occurrence rate of corticosteroid-related adverse effects similar to placebo (RD 5.3%; 95% CI: –3.9 to 14.5%; P=0.30).〈section xml:id="abs1-4"〉〈title type="main"〉Conclusions:Budesonide is significantly less effective than conventional corticosteroids for inducing remission in active Crohn’s disease, but the risk of corticosteroid-related adverse effects is significantly reduced. Budesonide is not effective in preventing relapse of Crohn’s disease after medically- or surgically-induced remission.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1046/j.1365-2036.2000.00867.x
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