Drugs in focus: Budesonide and its role in paediatric gastrointestinal disorders - PubMed
8 hours ago
- #Budesonide
- #Paediatric Gastroenterology
- #Inflammatory Bowel Disease
- Budesonide is a topical glucocorticoid with minimal systemic effects due to extensive first-pass hepatic metabolism, designed for targeted gastrointestinal (GI) delivery.
- It is used for Crohn's disease (CD), ulcerative colitis (UC), and eosinophilic oesophagitis (EoE), with efficacy in inducing remission in mild to moderate ileocaecal CD, especially in paediatric patients when exclusive enteral nutrition is not feasible.
- In UC, budesonide formulations (e.g., multimatrix tablets, rectal foam) are less effective than standard therapies and reserved for patients with contraindications; in EoE, topical swallowed budesonide shows promise for clinical and histological remission in children.
- Despite fewer systemic adverse effects, long-term use risks growth suppression and hypothalamic-pituitary-adrenal axis suppression, requiring careful monitoring.
- Guidelines, such as ESPGHAN/ECCO, recommend budesonide as an alternative in selected paediatric cases, emphasizing alignment with disease phenotype, formulation properties, and patient-specific considerations.