Oo. Thomsen et al., LACK OF ADRENAL-GLAND SUPPRESSION WITH BUDESONIDE ENEMA IN ACTIVE DISTAL ULCERATIVE-COLITIS - A PREDNISOLONE-CONTROLLED 8-WEEK STUDY, European journal of gastroenterology & hepatology, 6(6), 1994, pp. 507-511
Objective: To compare the effect of two glucocorticosteroid enemas, bu
desonide and prednisolone, on adrenal gland function in patients with
active distal ulcerative colitis. Design: A randomized, controlled, in
vestigator-blind study. Setting: A multicentre study among outpatients
from three Danish gastroenterology departments participating in a Sca
ndinavian multicentre study. Patients: The study included 26 patients
with active distal ulcerative colitis, with a median disease duration
of 6.5 years and a median duration of the current disease exacerbation
of 26 days. Intervention: Bedtime retention enemas, budesonide (2 mg/
100 ml), or prednisolone disodium phosphate (25 mg/100 ml) were admini
stered daily for up to 8 weeks. Adrenocorticotropic hormone (ACTH) tes
ts were performed at entry and after 4 and 8 weeks of treatment. Resul
ts: Baseline plasma cortisol values were significantly suppressed afte
r 4 and 8 weeks of prednisolone treatment, but remained unchanged duri
ng budesonide treatment. In the prednisolone group at weeks 4 and 8, p
lasma cortisol levels were below 500 nmol/l 30 min after ACTH injectio
n in eight out of 14 and four out of nine patients, respectively. By c
ontrast, the ACTH tests were normal in the budesonide-treated patients
. Conclusion: Budesonide enema is as effective as prednisolone enema i
n the treatment of active distal ulcerative colitis and does not suppr
ess adrenal gland function.