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Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study

During the COVID-19 pandemic many IBD units chose Budesonide MMX (Cortiment) as the first-line treatment for flares of ulcerative colitis (UC) in outpatients for its favourable side effect profile. This retrospective study of all UC patients treated with oral steroids between 1 March 2019–30 June 20...

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Autores principales: Rosiou, Konstantina, Ong Ming San, Elaine, Kumar, Aditi, Esquivel, Kim, Almas, Saima, Stokes, Daniel, Ng, Tze, Jayasooriya, Nishani, Ranasinghe, Ian, Pollok, Richard, Brookes, Matthew, Selinger, Christian P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509767/
https://www.ncbi.nlm.nih.gov/pubmed/34640345
http://dx.doi.org/10.3390/jcm10194329
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author Rosiou, Konstantina
Ong Ming San, Elaine
Kumar, Aditi
Esquivel, Kim
Almas, Saima
Stokes, Daniel
Ng, Tze
Jayasooriya, Nishani
Ranasinghe, Ian
Pollok, Richard
Brookes, Matthew
Selinger, Christian P.
author_facet Rosiou, Konstantina
Ong Ming San, Elaine
Kumar, Aditi
Esquivel, Kim
Almas, Saima
Stokes, Daniel
Ng, Tze
Jayasooriya, Nishani
Ranasinghe, Ian
Pollok, Richard
Brookes, Matthew
Selinger, Christian P.
author_sort Rosiou, Konstantina
collection PubMed
description During the COVID-19 pandemic many IBD units chose Budesonide MMX (Cortiment) as the first-line treatment for flares of ulcerative colitis (UC) in outpatients for its favourable side effect profile. This retrospective study of all UC patients treated with oral steroids between 1 March 2019–30 June 2019 and 1 March 2020–30 June 2020 aimed to compare Cortiment with Prednisolone in routine clinical practice. Outcomes included the need for hospitalisation for acute severe ulcerative colitis, symptoms at four weeks and end of treatment, and the need for rescue Prednisolone. The 2019 and 2020 cohorts did not differ at the baseline. Cortiment prescriptions rose from 24.5% in 2019 to 70.1% in 2020 (p < 0.001). At week four there were significant differences between 2019 and 2020 in mean bowel frequency (3.49 vs. 5.85, p = 0.001), rectal bleeding <50% (89.7% vs. 73.1% of patients, p = 0.039), and physician global assessment (PGA) (39.2% vs. 19.8% in remission, p = 0.045). There was no significant difference in hospital admissions, rectal bleeding, and PGA at week eight. Rescue Prednisolone was required in 10% of Cortiment patients in 2019 vs. 31.3% in 2020 (p = 0.058). Active IBD is associated with worse COVID-19 outcomes prompting the careful evaluation of the choice of first-line steroid for UC, as Cortiment was associated with worse outcomes at four weeks.
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spelling pubmed-85097672021-10-13 Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study Rosiou, Konstantina Ong Ming San, Elaine Kumar, Aditi Esquivel, Kim Almas, Saima Stokes, Daniel Ng, Tze Jayasooriya, Nishani Ranasinghe, Ian Pollok, Richard Brookes, Matthew Selinger, Christian P. J Clin Med Article During the COVID-19 pandemic many IBD units chose Budesonide MMX (Cortiment) as the first-line treatment for flares of ulcerative colitis (UC) in outpatients for its favourable side effect profile. This retrospective study of all UC patients treated with oral steroids between 1 March 2019–30 June 2019 and 1 March 2020–30 June 2020 aimed to compare Cortiment with Prednisolone in routine clinical practice. Outcomes included the need for hospitalisation for acute severe ulcerative colitis, symptoms at four weeks and end of treatment, and the need for rescue Prednisolone. The 2019 and 2020 cohorts did not differ at the baseline. Cortiment prescriptions rose from 24.5% in 2019 to 70.1% in 2020 (p < 0.001). At week four there were significant differences between 2019 and 2020 in mean bowel frequency (3.49 vs. 5.85, p = 0.001), rectal bleeding <50% (89.7% vs. 73.1% of patients, p = 0.039), and physician global assessment (PGA) (39.2% vs. 19.8% in remission, p = 0.045). There was no significant difference in hospital admissions, rectal bleeding, and PGA at week eight. Rescue Prednisolone was required in 10% of Cortiment patients in 2019 vs. 31.3% in 2020 (p = 0.058). Active IBD is associated with worse COVID-19 outcomes prompting the careful evaluation of the choice of first-line steroid for UC, as Cortiment was associated with worse outcomes at four weeks. MDPI 2021-09-23 /pmc/articles/PMC8509767/ /pubmed/34640345 http://dx.doi.org/10.3390/jcm10194329 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rosiou, Konstantina
Ong Ming San, Elaine
Kumar, Aditi
Esquivel, Kim
Almas, Saima
Stokes, Daniel
Ng, Tze
Jayasooriya, Nishani
Ranasinghe, Ian
Pollok, Richard
Brookes, Matthew
Selinger, Christian P.
Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study
title Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study
title_full Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study
title_fullStr Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study
title_full_unstemmed Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study
title_short Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study
title_sort comparative outcomes of budesonide mmx versus prednisolone for ulcerative colitis: results from a british retrospective multi-centre real-world study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509767/
https://www.ncbi.nlm.nih.gov/pubmed/34640345
http://dx.doi.org/10.3390/jcm10194329
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