Collagenous Colitis Treatment: Mesalamine or Budesonide?
the MPR take:
Although oral mesalamine has been proposed as a possible treatment for collagenous colitis, it turns out oral budesonide is a safer and more effective option. In a study published in the journal Gastroenterology, the two therapies were evaluated in a group of patients with active collagenous colitis. Clinical remission at 8 weeks (£3 stools/day) was the primary endpoint of the study. Patients were given either budesonide 9mg once daily, mesalamine 3g once daily, or placebo. At week 8, the budesonide group had a greater percentage of patients in clinical remission compared to placebo. Budesonide was also shown to be superior to mesalamine. Significant improvement was seen in mucosal histology and stool consistency with budesonide; it also alleviated abdominal pain. Based on the study results, budesonide was shown to be effective and safe in the short-term treatment of collagenous colitis; short-term mesalamine therapy looks to be ineffective.
Studies reporting that budesonide is effective for the treatment of collagenous colitis have been small and differed in efficacy measures. Mesalamine has been proposed as a treatment option for collagenous colitis, although its efficacy has never been investigated in placebo-controlled trials. ...
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