Bowel frequency (night) and urgent defecation are improved by budesonide foam in patients with ulcerative colitis: a retrospective observational study

Abstract Introduction Patients with ulcerative colitis (UC) are known to have a significantly poor quality of life due to bowel frequency (night) and urgent defecation. Budesonide foam is a topical medication that was approved in Japan in 2017 for the treatment of UC. However, its efficacy in the tr...

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Main Authors: Ryosuke Miyazaki, Toshiyuki Sakurai, Mariko Shimada, Yuko Iwashita, Naoki Shibuya, Yoshihiro Akita, Haruna Miyashita, Yuki Maruyama, Masayuki Saruta
Format: Article
Language:English
Published: BMC 2022-06-01
Series:BMC Gastroenterology
Subjects:
Online Access:https://doi.org/10.1186/s12876-022-02388-6
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author Ryosuke Miyazaki
Toshiyuki Sakurai
Mariko Shimada
Yuko Iwashita
Naoki Shibuya
Yoshihiro Akita
Haruna Miyashita
Yuki Maruyama
Masayuki Saruta
author_facet Ryosuke Miyazaki
Toshiyuki Sakurai
Mariko Shimada
Yuko Iwashita
Naoki Shibuya
Yoshihiro Akita
Haruna Miyashita
Yuki Maruyama
Masayuki Saruta
author_sort Ryosuke Miyazaki
collection DOAJ
description Abstract Introduction Patients with ulcerative colitis (UC) are known to have a significantly poor quality of life due to bowel frequency (night) and urgent defecation. Budesonide foam is a topical medication that was approved in Japan in 2017 for the treatment of UC. However, its efficacy in the treatment of bowel frequency (night) or urgent defecation is unknown. This study aimed to explore the efficacy of budesonide foam for the alleviation of these symptoms. Methods UC patients who received budesonide foam between December 2017 and January 2020 at the Jikei University School of Medicine in Tokyo were enrolled. The simple clinical colitis activity index (SCCAI) was evaluated at the start of budesonide foam treatment and 2 and 6 weeks later in patients who initially scored ≥ 1 for bowel frequency (night) and urgent defecation, respectively. We also studied the effect of budesonide foam on remaining symptoms in patients who had used 5-aminosalicylic acid (5-ASA) topical treatment, those with SCCAI ≥ 3, and those in remission with residual symptoms (SCCAI 1 or 2). Results Of the 233 enrolled patients, 102 were eligible for the study. In 36 patients with bowel frequency (night) treated with budesonide foam were significantly effective, score in SCCAI decreased from 1.17 ± 0.45 at baseline to 0.53 ± 0.61 at week 2 (p < 0.0001) and 0.17 ± 0.38 at week 6 (p < 0.0001). In 45 patients with urgent defecation score in SCCAI decreased significantly from 1.33 ± 0.52 at baseline to 0.44 ± 0.59 at week 2 (p < 0.0001) and 0.22 ± 0.40 at week 6 (p < 0.0001). Of 22 patients who switched from topical 5-ASA administration to budesonide foam, nine at week 2 (41%) and 11 (50%) at week 6 were improved with no symptoms, and there were no cases of worsened symptoms. No severe side effects associated with budesonide foam were observed. Conclusion Budesonide foam administration significantly improves both bowel frequency (night) and urgent defecation-related UC activity and is also effective for the patients who were refractory to topical 5-ASA administration.
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spelling doaj.art-db77b0ffadbe4ff191c98d9d45052e722022-12-22T02:38:17ZengBMCBMC Gastroenterology1471-230X2022-06-012211710.1186/s12876-022-02388-6Bowel frequency (night) and urgent defecation are improved by budesonide foam in patients with ulcerative colitis: a retrospective observational studyRyosuke Miyazaki0Toshiyuki Sakurai1Mariko Shimada2Yuko Iwashita3Naoki Shibuya4Yoshihiro Akita5Haruna Miyashita6Yuki Maruyama7Masayuki Saruta8Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineAbstract Introduction Patients with ulcerative colitis (UC) are known to have a significantly poor quality of life due to bowel frequency (night) and urgent defecation. Budesonide foam is a topical medication that was approved in Japan in 2017 for the treatment of UC. However, its efficacy in the treatment of bowel frequency (night) or urgent defecation is unknown. This study aimed to explore the efficacy of budesonide foam for the alleviation of these symptoms. Methods UC patients who received budesonide foam between December 2017 and January 2020 at the Jikei University School of Medicine in Tokyo were enrolled. The simple clinical colitis activity index (SCCAI) was evaluated at the start of budesonide foam treatment and 2 and 6 weeks later in patients who initially scored ≥ 1 for bowel frequency (night) and urgent defecation, respectively. We also studied the effect of budesonide foam on remaining symptoms in patients who had used 5-aminosalicylic acid (5-ASA) topical treatment, those with SCCAI ≥ 3, and those in remission with residual symptoms (SCCAI 1 or 2). Results Of the 233 enrolled patients, 102 were eligible for the study. In 36 patients with bowel frequency (night) treated with budesonide foam were significantly effective, score in SCCAI decreased from 1.17 ± 0.45 at baseline to 0.53 ± 0.61 at week 2 (p < 0.0001) and 0.17 ± 0.38 at week 6 (p < 0.0001). In 45 patients with urgent defecation score in SCCAI decreased significantly from 1.33 ± 0.52 at baseline to 0.44 ± 0.59 at week 2 (p < 0.0001) and 0.22 ± 0.40 at week 6 (p < 0.0001). Of 22 patients who switched from topical 5-ASA administration to budesonide foam, nine at week 2 (41%) and 11 (50%) at week 6 were improved with no symptoms, and there were no cases of worsened symptoms. No severe side effects associated with budesonide foam were observed. Conclusion Budesonide foam administration significantly improves both bowel frequency (night) and urgent defecation-related UC activity and is also effective for the patients who were refractory to topical 5-ASA administration.https://doi.org/10.1186/s12876-022-02388-6Budesonide foamBowel frequency (night)Urgent defecation5-ASA topical treatment
spellingShingle Ryosuke Miyazaki
Toshiyuki Sakurai
Mariko Shimada
Yuko Iwashita
Naoki Shibuya
Yoshihiro Akita
Haruna Miyashita
Yuki Maruyama
Masayuki Saruta
Bowel frequency (night) and urgent defecation are improved by budesonide foam in patients with ulcerative colitis: a retrospective observational study
BMC Gastroenterology
Budesonide foam
Bowel frequency (night)
Urgent defecation
5-ASA topical treatment
title Bowel frequency (night) and urgent defecation are improved by budesonide foam in patients with ulcerative colitis: a retrospective observational study
title_full Bowel frequency (night) and urgent defecation are improved by budesonide foam in patients with ulcerative colitis: a retrospective observational study
title_fullStr Bowel frequency (night) and urgent defecation are improved by budesonide foam in patients with ulcerative colitis: a retrospective observational study
title_full_unstemmed Bowel frequency (night) and urgent defecation are improved by budesonide foam in patients with ulcerative colitis: a retrospective observational study
title_short Bowel frequency (night) and urgent defecation are improved by budesonide foam in patients with ulcerative colitis: a retrospective observational study
title_sort bowel frequency night and urgent defecation are improved by budesonide foam in patients with ulcerative colitis a retrospective observational study
topic Budesonide foam
Bowel frequency (night)
Urgent defecation
5-ASA topical treatment
url https://doi.org/10.1186/s12876-022-02388-6
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