Source: DGNews  |  Posted 9 years ago

By Andrew Bowser
Special to DG News

SEATTLE, WA -- October 24, 2002 -- Patients with active Crohn's disease who receive modified-release budesonide (Entocort EC) lose less bone mass than patients who receive the standard corticosteroid prednisolone, according to results of a randomised trial presented here October 22 at the 67th annual scientific meeting of the American College of Gastroenterology (ACG).

"Modified-release budesonide has a significant advantage in preservation of bone mass of the lumbar spine, compared with equipotent doses of prednisolone," said Erik J. Schoon, MD, of the University Hospital Maastricht, in Maastricht, Netherlands.

Dr. Schoon reported results of a trial that included 272 patients with moderately active ileo-cecal Crohn's disease who were not previously treated with oral steroids. Bone mass was investigated using a dual energy X-ray absorptiometry (DEXA) scan of the lumbar spine and a lateral X-ray of the thoracic and lumbar spine. Patients were followed for up to 24 months.

Patients who had never taken steroids had a significant benefit from budesonide. After up to 24 months of follow-up, bone loss was 1.04 percent in the budesonide group, versus 3.84 percent in the prednisolone group (p=0.0084). The effect was pronounced in the first half year of treatment.

There was no difference in bone loss for patients who had previously used steroids, but those patients already had lower bone density when the trial started, Dr. Schoon said.

There were also fewer steroid-related side effects, particularly rounding of the face, in the group of patients who received modified-release budesonide.

Osteoporosis is a well-known complication of Crohn's disease, due to corticosteroid use or the disease itself, Dr. Schoon noted.

"Potentially, budesonide damages the bone matrix less than prednisolone," he concluded.