- |||||||||| budesonide / Generic mfg., paracetamol / Generic mfg., duloxetine / Generic mfg.
Autoimmune Hepatitis Presenting Without Autoantibodies: A Diagnostic Challenge (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1011;
Due to concern for liver toxicity, patient’s home tylenol and duloxetine were held without significant improvement in her transaminitis or symptoms...Patient was started on budesonide with resolution of her transaminitis and symptomatic improvement...Atypical autoantibodies that may assist in the diagnosis of AIH when ANA, ASMA, and anti-LKM-1 are negative include atypical perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) and anti-soluble liver antigen/liver pancreas antibody (anti-SLA/LP). Clinicians with a high degree of suspicion for AIH should be aware that it can present without autoantibodies because when absent, appropriate diagnosis and treatment can be delayed.
- |||||||||| budesonide / Generic mfg.
A Rare Presentation of Esophageal Lichen Planus in a Patient With Collagenous Gastritis and Duodenitis: A Case Study (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_721;
A swallowed budesonide slurry markedly improved her dysphagia and helped regain weight...Histological findings of collagenous gastritis and duodenitis. (A) Duodenum depicting signs of villous atrophy and subepithelial collagen deposition with background chronic inflammation; (B) Gastric antrum depicting subepithelial collagen deposition with background chronic inflammation.
- |||||||||| Ocaliva (obeticholic acid) / Intercept
Review, Journal: Update on the Pharmacological Treatment of Primary Biliary Cholangitis. (Pubmed Central) - Aug 27, 2022
Ursodeoxycholic acid (UDCA) is the first-line therapy used for the treatment of PBC...Obeticholic acid (OCA) is registered in many countries for PBC, and fibrates also seem to be effective in ameliorating biochemistry alteration and symptoms typical of PBC...Since an insufficient amount of data is currently available about the effect of these novel approaches on robust clinical endpoints, such as transplant-free survival, their clinical approval needs to be supported by the consistent improvement of these parameters. The intensive research in this field will hopefully lead to a novel treatment landscape for PBC in the near future, with innovative therapies based on the combination of multiple agents acting on different pathogenetic mechanisms.
- |||||||||| Comirnaty (tozinameran) / Pfizer, Fosun Pharma, BioNTech
Journal: SARS-CoV-2 vaccination can elicit a CD8 T-cell dominant hepatitis. (Pubmed Central) - Aug 24, 2022
Moreover, its good clinical safety profile makes it a promising treatment that ought to be promoted and used widely. COVID-19 vaccination can elicit a distinct T cell-dominant immune-mediated hepatitis with a unique pathomechanism associated with vaccination-induced antigen-specific tissue-resident immunity requiring systemic immunosuppression.
- |||||||||| montelukast / Generic mfg., budesonide / Generic mfg.
Journal: Preliminary evidence in treatment of eosinophilic gastroenteritis in children: A case series. (Pubmed Central) - Aug 22, 2022
COVID-19 vaccination can elicit a distinct T cell-dominant immune-mediated hepatitis with a unique pathomechanism associated with vaccination-induced antigen-specific tissue-resident immunity requiring systemic immunosuppression. Methylprednisolone/montelukast is still the best treatment for children with low eosinophil infiltration ( 14%).
- |||||||||| Journal: Machine Learning Can Predict the Probability of Biologic Therapy in Patients with Inflammatory Bowel Disease. (Pubmed Central) - Aug 14, 2022
In summary, this study reveals the advantages of ML-based models in predicting biologic therapy in IBD patients based on pre-treatment and demographic variables. There is a need for further studies in this regard that take into account individual patient characteristics, i.e., genetics and gut microbiota, to adequately address the challenges of finding optimal treatment strategies for patients with IBD.
- |||||||||| budesonide / Generic mfg.
Journal, Monotherapy, Checkpoint inhibition: Immune-checkpoint inhibitor-associated grade 3 hepatotoxicity managed with enteric-coated budesonide monotherapy: A case report. (Pubmed Central) - Aug 12, 2022
Therefore, budesonide may be a potentially attractive option for the management of ICPI-associated liver injury in cases where corticosteroid treatment is necessary due to its safety profile and the potential advantage of faster immunotherapy rechallenge in selected patients without requiring dose tapering, in contrast to systemically acting corticosteroids. Clinical trials should be conducted in the future in order to validate or refute these findings.
- |||||||||| budesonide / Generic mfg.
Journal: Inhalable Nano-Dimpled Microspheres Containing Budesonide-PLGA for Improved Aerodynamic Performance. (Pubmed Central) - Aug 11, 2022
Furthermore, it was confirmed that the dimpled surface of MSs could cause movement away from the bronchial surface, which helps the MSs travel into the deep lung using computational fluid dynamics. The dimpled-surface MSs showed a higher fine particle fraction value compared to smooth-surface MSs in the Andersen Cascade Impactor, and surface roughness like dimples on microspheres could improve aerosolization and lung deposition.
- |||||||||| prednisone / Generic mfg., budesonide / Generic mfg.
Clinical, Journal: A Comparative Analysis of Drug Therapy, Disease Phenotype, and Health Care Outcomes for Men and Women with Inflammatory Bowel Disease. (Pubmed Central) - Aug 10, 2022
The dimpled-surface MSs showed a higher fine particle fraction value compared to smooth-surface MSs in the Andersen Cascade Impactor, and surface roughness like dimples on microspheres could improve aerosolization and lung deposition. These findings highlight differences in disease course and treatment approaches between men and women with IBD and support the consideration of sex and gender when researching disease outcomes.
- |||||||||| Veramyst (fluticasone furoate nasal spray) / GSK
Journal: Inhaled glucocorticoid-induced metabolome changes in asthma. (Pubmed Central) - Aug 5, 2022
Dose-dependent metabolomic changes occurred with inhaled GCs but were seen predominately at highest/supratherapeutic doses, supporting the safety of low and mid therapeutic doses. At comparable therapeutic doses (FF 100, FP 500 and BUD 800 µg/day), FF had the least effect on the most sensitive markers (adrenal steroids) vs BUD and FP.
- |||||||||| budesonide / Generic mfg.
Journal: Microscopic colitis: Etiopathology, diagnosis, and rational management. (Pubmed Central) - Aug 2, 2022
In microscopic colitis induced by checkpoint inhibitors, a drug class used increasingly for a wide range of malignancies, a more aggressive therapeutic approach with biologics introduced early seems reasonable. However, particular attention needs to be drawn to the existence of incomplete forms of microscopic colitis with the risk of being overlooked in routine clinical settings.
- |||||||||| Journal: Management of Acute and Chronic Pouchitis. (Pubmed Central) - Jul 30, 2022
Pouchitis represents a spectrum of disease phenotypes, ranging from acute antibiotic responsive pouchitis to chronic antibiotic refractory pouchitis. The management of pouchitis is primarily directed by the disease phenotype.
- |||||||||| budesonide / Generic mfg.
Retrospective data, Review, Journal: A meta-analysis on randomized controlled trials of treating eosinophilic esophagitis with budesonide. (Pubmed Central) - Jul 29, 2022
It is safe to take budesonide for a long time, and this drug is a relatively ideal option for drug treatment of eosinophilic esophagitis at present, so it is worthy of clinical application.Key MessagesWe used high-quality randomised controlled trials to meta-update the previous results to further confirm the clinical efficacy and safety of budesonide.Oral budesonide in the treatment of eosinophilic esophagitis is significantly better than the placebo control group. We have confirmed the value of its clinical application and promotion by including more high-quality randomised controlled trials.We also found that the efficacy of budesonide in patients is not dose-dependent, and more research is needed to confirm this.
- |||||||||| Dupixent (dupilumab) / Sanofi, Regeneron
Journal: A Case Series on the Use of Dupilumab for Treatment of Refractory Eosinophilic Gastrointestinal Disorders. (Pubmed Central) - Jul 28, 2022
These patients had extra-esophageal forms of EGID with two patients failing to achieve remission on standard-of-care therapies and one patient experiencing significant side effects on swallowed budesonide therapy. The reduction in mucosal eosinophilia in several GI tract segments in these three patients highlights a new potential clinical indication for dupilumab in the treatment of pediatric EGID patients.
- |||||||||| budesonide / Generic mfg.
Clinical, Review, Journal: Budesonide In The First Line Treatment Of Patients With Autoimmune Hepatitis. (Pubmed Central) - Jul 23, 2022
Since the original trial comparing budesonide with prednisone in 2010, it is recommended as an effective alternative for the treatment of non-severe acute or chronic autoimmune hepatitis. In this document, we review the general pharmacologic properties of glucocorticoids, the available evidence for the use of budesonide as first line option for autoimmune hepatitis as well as the safety profile of the drug.
- |||||||||| budesonide / Generic mfg., fluticasone / Generic mfg.
Journal: Current treatment options and long-term outcomes in patients with eosinophilic esophagitis. (Pubmed Central) - Jul 23, 2022
Further knowledge on eosinophilic esophagitis phenotypes is needed to ascertain who will benefit best from sustained therapy. Unanswered questions include an adequate definition for sustained remission, best strategies for maintenance drugs and diets, enhancement of treatment adherence, and proper monitoring for long-term surveillance.
- |||||||||| Ocaliva (obeticholic acid) / Intercept
HEPATOBILIARY DISORDERS IN INFLAMMATORY BOWEL DISEASE: WHAT COULD BE THE OPTIMAL MANAGEMENT WHEN PRIMARY BILIARY CHOLANGITIS PRECEDES THE ONSET OF CROHN ILEITIS? A SIXTY-SIX YEARS OLD FEMALE PATIENT CASE REPORT (Science Lounge) - Jul 20, 2022 - Abstract #UEGW2022UEGW_2730;
Unanswered questions include an adequate definition for sustained remission, best strategies for maintenance drugs and diets, enhancement of treatment adherence, and proper monitoring for long-term surveillance. Clinical Case Summary: Hepatobiliary disorders’ association with inflammatory bowel diseases (IBDs) has been widely proven.However, the concomitance of Primary Biliary Cholangitis (PBC) and Crohn’s disease (CD) is anecdotical, usually described in male young patients with a diagnosis of IBD preceding the onset of PBC.We report the case of a 66-year-old female patient with pre-existent PBC at the moment of the CD-ileitis identification.She was admitted for recurrent abdominal colic pain and irrepressible chronic diarrhea; her family history didn’t reveal any inflammatory or neoplastic gut disorders; PBC and Hashimoto’s thyroiditis were the highlighted comorbidities.PBC was diagnosed 5 years before,treated for two years with the administration of 15 mg/Kg/die ursodeoxycholic acid (UDCA) which,because of the severe diarrhea, was then stopped.After an inconclusive chronic diarrhea diagnostic work-up (table), further examinations were performed, including colonoscopy and MRI-enterography, both assessing a picture suitable for CD.The combination of the clinical, endoscopic, and radiologic findings realized the final diagnosis of Crohn’s Ileitis causing ileal substenosis in a patient with PBC.Given the UDCA intolerance,an oral monotherapy treatment using obeticholic acid 5 mg/die was prescribed.Considering the concomitant diagnosis of ileal-CD and the potential benefits described as off-label therapy on PBC patients,budesonide 9 mg/die per os was also administered.One month after discharge, an improvement was observed both in cholestasis indexes and gastrointestinal symptoms.According to our experience, all IBD patients should be constantly screened for hepatobiliary manifestations, to provide an early setting of a tailored therapeutic path.Table >
- |||||||||| Simponi (golimumab) / Merck (MSD), Mitsubishi Tanabe, J&J
UNUSUAL DIAGNOSIS IN A PATIENT WITH DYSPEPSIA (Science Lounge) - Jul 20, 2022 - Abstract #UEGW2022UEGW_2631;
Clinical Case Summary: This is a case of a 42-year-old man with seronegative spondyloarthropathy and primary biliary cholangitis under golimumab and ursodeoxycholic acid...The patient started treatment with budesonide with an improvement of symptoms...It is classified as either secondary (most commonly associated with celiac disease or Helicobacter pylori gastritis) or idiopathic. Lymphocytic gastritis is of clinical importance since its recognition should prompt further clinical evaluation for other disorders.
- |||||||||| famotidine / Generic mfg., budesonide / Generic mfg.
Latrogenic Cushing Syndrome after Concomitant Oral Controlled-Release Budesonide and Famotidine Therapy () - Jul 16, 2022 - Abstract #ENDO2022ENDO_1797;
However, when taken with famotidine, a medication that decreases acids in the stomach, the coating of the budesonide breaks down early and this increases the absorption of the drug, resulting in steroid excess that has negative effects in the adrenal hormone system. This abstract aims to increase awareness of drug interaction between these two drugs that results in adverse effects described in this case report.
- |||||||||| itraconazole / Generic mfg.
Adrenal Insufficiency After Combined Treatment of Itraconazole and Triamcinolone () - Jul 16, 2022 - Abstract #ENDO2022ENDO_1132;
We believe that he had an atypical presentation of both primary adrenal insufficiency (PAI) due to adrenal histoplasmosis and central adrenal insufficiency (CAI) from the combined use of itraconazole and triamcinolone. The Na+, K+, aldosterone and PRA levels support a diagnosis of PAI; whereas the suppressed ACTH level supports CAI.
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