INTESTINE Vol.22 No.3(10)

Theme Recent advance in the treatment of IBD based on the pathogenesis
Title Oral budesonide for inflammatory bowel diseases
Publish Date 2018/05
Author Mikio Kawai Division of Internal Medicine, Department of Inflammatory Bowel Disease, Hyogo College of Medicine
Author Shiro Nakamura Division of Internal Medicine, Department of Inflammatory Bowel Disease, Hyogo College of Medicine
[ Summary ] Anti-TNF treatment has significantly improved the clinical course of inflammatory bowel diseases (IBD) such as Crohn's disease (CD) and ulcerative colitis. However, therapeutic efficacy may wane over time, resulting in secondary loss of response. Therefore, novel therapeutic options for IBD are eagerly anticipated. Budesonide is a corticosteroid with topical anti-inflammatory potency but low systemic potency. Oral budesonide for CD was approved in Japan in 2016. It is an antedrug steroid which is designed to be absorbed in the ileum and ascending colon. It is suitable for induction of remission in mild to moderately active CD. Although the frequency of steroid use for CD is lower in Japan than in Western countries, the use of this drug can reduce the side effects of systemic potency, and increase safety. Consequently, this drug may be used in various clinical situations, including onset and recurrent exacerbation of CD, as well as secondary loss of response to biologics. Oral budesonide may be a safe and promising therapeutic option and contribute to better management of CD.
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