Budesonide MMX for the Induction of Remission of Mild to Moderate Ulcerative Colitis: A Pooled Safety Analysis

• Published in: Journal of Crohn's and colitis 2015-09, Vol.9 (9), p.738-746
• Main Authors: Lichtenstein, Gary R., Travis, Simon, Danese, Silvio, D’Haens, Geert, Moro, Luigi, Jones, Richard, Huang, Michael, Ballard, E. David, Bagin, Robert, Hardiman, Yun, Collazo, Raul, Sandborn, William J.
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents - therapeutic use; Biomarkers - blood; Budesonide - therapeutic use; Colitis, Ulcerative - blood; Colitis, Ulcerative - drug therapy; Drug Administration Schedule; Drug Monitoring; Female; Humans; Hydrocortisone - blood; Induction Chemotherapy; Male; Middle Aged; Original; Severity of Illness Index; Treatment Outcome; Young Adult
• ISSN: 1873-9946; 1876-4479
• DOI: 10.1093/ecco-jcc/jjv101

Background and aims: Cumulative safety and tolerability of budesonide MMX, a once-daily oral corticosteroid for inducing mild to moderate ulcerative colitis remission, was examined. Methods: Data from three randomized, double-blind, placebo-controlled, phase II or III studies [budesonide MMX 9mg, 6mg, or 3mg for 8 weeks]; one phase II study [randomisation to budesonide MMX 9mg or placebo for 4 weeks, then open-label budesonide MMX 9mg for 4 weeks]; and one open-label study [budesonide MMX 9mg for 8 weeks] were pooled. Results: Patients randomised to budesonide MMX 9mg [n = 288], 6mg [n = 254], or placebo [n = 293] had similar rates of adverse events [AEs] [27.1%, 24.8%, and 23.9%, respectively] and serious AEs [2.4%, 2.0%, and 2.7%, respectively]; treatment-related AEs and serious AEs were reported by 11.8% and 13.5%, and 5.9% and 2.2%, respectively, of patients receiving budesonide MMX 3mg [n = 17] or open-label budesonide MMX 9mg [n = 89]. Mean morning plasma cortisol concentrations were normal from baseline to final visit across randomised groups; in patients receiving open-label budesonide, mean cortisol concentration was 129.9 nmol/l after 4 weeks, returning to normal concentrations at final visit. Budesonide MMX was not associated with an overall increased risk for glucocorticoid-related adverse effects. Conclusions: Budesonide MMX 9mg was associated with normal mean cortisol concentrations at final visit and an AE incidence comparable to placebo. Overall, budesonide MMX was safe and well tolerated for inducing remission of patients with mild to moderate ulcerative colitis.