A proposed treatment algorithm for mild to moderate ulcerative colitis—with an emphasis on budesonide foam and mucosal healing
We read with great interest the paper recently published by Naganuma et al.  on the budesonide foam in mild to moderate ulcerative colitis (UC). Indeed, second-generation corticosteroids, such as budesonide, can become a reliable “intermediate layer” between mesalazine and systemic corticosteroids in the UC treatment pyramid. In this regard, we would like to supplement the current treatment algorithm considering data from rectal budesonide studies [1, 2, 3, 4, 5, 6].
Earlier, two large studies have shown similar efficacy and safety of budesonide foam compared with hydrocortisone foam , as well as compared with budesonide enema in patients with distal UC . Furthermore, in the second study, most patients (84%) preferred foam because of its better tolerability and easier application .
More recently, two large, randomized, placebo-controlled, phase 3 studies demonstrated that a significantly greater percentage of patients with active, mild to moderate ulcerative proctitis or...
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Conflict of Interest
The authors declare that they have no conflict of interest. Authors must indicate whether or not they have/had a financial relationship (within the last 3 years) with any organization that sponsored the research. They should also confirm that they have full control of all primary data and they agree to allow the journal to review their data if requested.
- 1.Naganuma M, Aoyama N, Tada T, et al. Complete mucosal healing of distal lesions induced by twice-daily budesonide 2-mg foam promoted clinical remission of mild-to-moderate ulcerative colitis with distal active inflammation: double-blind, randomized study. J Gastroenterol. 2018;53(4):494–506. https://doi.org/10.1007/s00535-017-1376-4.CrossRefPubMedGoogle Scholar
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