- |||||||||| budesonide / Generic mfg.
Reactive Hypereosinophilia in a Toddler with Very Early Onset Inflammatory Bowel Disease (Monitor 10) - Sep 14, 2023 - Abstract #ACAAI2023ACAAI_712;
Discussion This patient's hypereosinophilia was secondary to underlying gastrointestinal inflammation, likely from developing inflammatory bowel disease. This case demonstrates the importance of maintaining a broad differential in evaluating patients with HE and tailoring treatment to the underlying cause, rather than specifically targeting the eosinophils themselves.
- |||||||||| Filspari (sparsentan) / Travere Therap, CSL Behring
Review, Journal: IgA nephropathy: a review of existing and emerging therapies. (Pubmed Central) - Sep 8, 2023
A multitude of clinical trials is ongoing, opening multiple opportunities for enrollment. In this brief review we discuss the current approach to the management of IgAN and highlight the ongoing clinical trials.
- |||||||||| budesonide / Generic mfg., fluticasone / Generic mfg.
Review, Journal: Impact of inhaled and intranasal corticosteroids on glucose metabolism and diabetes mellitus: A mini review. (Pubmed Central) - Sep 7, 2023
While more research evaluating the risk of ICS/INS for DM-related adverse events is needed, high doses of ICS/INS should be avoided when possible. The following strategies for ICS/INS dose minimization can be considered: Use of non-pharmacological measures (trigger avoidance, smoking cessation, vaccination to avoid infection), control of comorbid conditions, use of non-ICS-containing medications, inter-mittent rather than regular ICS dosing, and appropriate de-escalation of high ICS doses.
- |||||||||| Advantan (methylprednisolone aceponate) / Bayer
Ulcers associated to the overuse of an antihemorroidal ointment containing ephedrine and benzocaine (e-Poster Hall) - Aug 30, 2023 - Abstract #EADV2023EADV_3768;
The following strategies for ICS/INS dose minimization can be considered: Use of non-pharmacological measures (trigger avoidance, smoking cessation, vaccination to avoid infection), control of comorbid conditions, use of non-ICS-containing medications, inter-mittent rather than regular ICS dosing, and appropriate de-escalation of high ICS doses. Patch tests were performed using the baseline series of the Grupo Espa
- |||||||||| budesonide / Generic mfg.
Journal: Systematic Identification of Copositivity Groups in Standard Series Patch Testing Through Hierarchical Clustering. (Pubmed Central) - Aug 2, 2023
Many were supported by prior literature, including formaldehyde releasers, cobalt-nickel-potassium dichromate, acrylates, 3-dimethylaminopropylamine-amidoamine-oleamidopropyl dimethylamine, alkyl glucosides, budesonide-hydrocortisone-17-butyrate, certain fragrances, compositae-sesquiterpene lactone mix, mercapto mix-mercaptobenzothiazole, carba mix-thiuram mix, and disperse orange-p-phenylenediamine...This retrospective cross-sectional analysis found that copositivity rates varied between allergens; allergens with extremely high positivity rates demonstrated nonspecific copositivity to multiple other allergens. Background correction based on positivity rates followed by hierarchical clustering confirmed prior known copositivity groups, contaminants and/or excipients leading to copositivity, and novel associations to guide contact avoidance.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD), Opdivo (nivolumab) / Ono Pharma, BMS, Yervoy (ipilimumab) / Ono Pharma, BMS
Recognition of Delayed-Onset Immune Checkpoint Inhibitor-Mediated Hepatotoxicity Treated With Budesonide: A Case Study Factoring in Pharmacokinetics of Immunotherapies (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4497;
Case Description/ A 58-year-old woman with a history of metastatic stage IV melanoma, treated with radiation, prior pembrolizumab (discontinued due to severe immune-mediated colitis), and then ipilimumab/nivolumab, was evaluated for unexplained elevations of liver enzymes...The patient was started on induction steroids with oral budesonide 9 mg/d with taper to 6 mg/d and 3 mg/d, for total of 42 days, and adjunct ursodiol 1000 mg/d, which yielded adequate liver biochemical remission...(B) Liver biopsy (H&E) showing marked architectural remodeling with areas of parenchymal collapse, mixed moderate portal inflammation with foci of lobular inflammation, endotheliitis, and evidence of mild bile duct injury. Abbreviations: ICI: immune checkpoint inhibitors; DIRE: delayed immune-related adverse event; ULN: upper limit of normal; AST: aspartate aminotransferase; ALT: alanine aminotransferase; ALP: alkaline phosphatase; GGT: gamma-glutamyl transferase.
- |||||||||| Bosulif (bosutinib) / Pfizer
Budesonide Can Successfully Treat Bosutanib-Induced Autoimmune Hepatitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4446;
This case highlights both a rare drug-induced autoimmune phenomenon, and the importance of individualizing treatment plans based on patient-specific factors. Figure: Figure 1: Trend in Liver Enzymes with Treatment
- |||||||||| Entyvio (vedolizumab) / Takeda
Microscopic to Macroscopic: A Case Highlighting Progression Along an Inflammatory Bowel Disease Spectrum (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4153;
Her diarrhea was refractory to budesonide therapy...The patient was treated with prednisone and Vedolizumab...The progression of MC to UC should be on the differential diagnosis when considering a patient whose symptoms remain refractory to conventional therapy, as has been highlighted by our case report. Figure: 1A) Crypt dropout (red bracket); prominent ganglion cells demonstrated by large cells within the lamina propria and submucosa with abundant foamy, eosinophilic cytoplasm (red stars) (10x objective (100x magnification), H&E) 1B) Severe scarring with congestion and a decreased mucosal vascular pattern with nodularity in the descending colon on subsequent colonoscopy 1C) Chromoscopy demonstrating decreased mucosal uptake of methylene blue in setting of severe scarring with congestion throughout the colon 1D) Polypoid colonic mucosa with low-grade dysplasia demonstrated by crowded, hyperchromatic, pencillate nuclei (red arrow; 10x objective (100x magnification), H&E)
- |||||||||| Clinical, Endoscopic and Histologic Features of Common Variable Immunodeficiency (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3869;
A total of 147 procedures were included (Table 1). The most common GI symptoms leading to endo evaluation were diarrhea (50%) and abdominal pain (29%); other indication included nausea (23%), weight loss (17%), vomiting (14%), and rarely (<10%): hematochezia/rectal bleeding, bloating, anorexia/early satiety, heartburn, dysphagia, iron and vitamin B12 deficiency.
- |||||||||| budesonide / Generic mfg.
A Rare Presentation of Eosinophilic-Appearing Lymphocytic Esophagitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3831;
He was prescribed PPI therapy and oral budesonide in applesauce...A) Upper third of esophagus showing eosinophilic esophagitis and stenosis. B) Middle third of esophagus showing eosinophilic esophagitis.
- |||||||||| Dupixent (dupilumab) / Sanofi, Regeneron
High-Dose Budesonide Improves PPI-Refractory NarrowCaliber Fibrostenotic Eosinophilic Esophagitis: A Case Report (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3756;
Prior to dupilumab, management of treatment-refractory narrow-caliber EoE was serial esophageal dilations, with concomitant risks...He was started on high-dose esomeprazole twice daily...Though steroids can prevent progression to fibrostenotic disease, they have not had a clear role in treating established disease. This case, therefore, suggests a role for oral viscous budesonide in treating fibrostenotic EoE that should be further characterized.
- |||||||||| budesonide / Generic mfg.
Alpha Gal Allergy Associated With Eosinophilic Gastroenteritis, Coincidence or Coexistence? (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3636;
This case, therefore, suggests a role for oral viscous budesonide in treating fibrostenotic EoE that should be further characterized. Based on biopsy findings, the patient was started on a budesonide taper...It is unclear whether it is directly associated alpha-gal; however, our patient
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD), BCA101 / Biocon
Immune-Mediated Cholangiopathic Toxicity: A Case of Immunotherapy-Related Sclerosing Cholangitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3390;
He was later switched to prednisone and mycophenolate mofetil as outpatient, and his liver enzymes slowly improved to ALT 49, AST 65, and ALP 193...No guidelines specific to treating IMCp exist. Evidence suggests IMCp is often steroid-refractory and early use of adjunctive therapies may be needed.
- |||||||||| pantoprazole / Generic mfg., budesonide / Generic mfg.
A Collagenous Conundrum (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3305;
There is no Helicobacter pylori, intestinal metaplasia or atrophy identified. The overall features are consistent with collagenous gastritis.
- |||||||||| Nucala (mepolizumab) / GSK
Eosinophilic Gastrointestinal Disease Presenting With Eosinophilic Hepatitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3000;
Management of these patients involves immunosuppression with systemic steroids, although there may also be a role for biologics such as anti-IL-5 agents. Eosinophilic hepatitis is an uncommon diagnosis yet should remain on the differential for patients with evidence of hepatitis and other hypereosinophilic syndromes.
- |||||||||| capecitabine / Generic mfg.
Drug-Induced Collagenous Colitis Secondary to Capecitabine (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2710;
Three years ago, the patient was diagnosed with grade 3 invasive ductal carcinoma and lymphovascular invasion and underwent chemotherapy with doxorubicin, pegfilgrastim, and cyclophosphamide...The patient was prescribed budesonide...Several studies have reported the effect of these medications and collagenous colitis, however, there is no evidence for a causal relationship. While these studies discussed many drugs, from our review of the literature, none have noted capecitabine as a potential causative agent for drug-induced collagenous colitis.
- |||||||||| budesonide / Generic mfg., fluticasone / Generic mfg.
Topical Steroids: An Effective Treatment Option for Lymphocytic Esophagitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2395;
She took budesonide for 3 months; while she endorsed improvement in dysphagia, repeat EGD showed persistent LE...She received one month of inhaled fluticasone without improvement in symptoms; however, repeat EGD showed resolution of LE...Figure: Figure 1. Histologic sections show stratified epithelium with numerous intraepithelial lymphocytes and intraepithelial edema (spongiosis) with occasional dyskeratotic cells.
- |||||||||| budesonide / Generic mfg.
A Rare Case of Microscopic Colitis With Adjacent Metastatic Serous Carcinoma and Focal Intramucosal Carcinoma of the Colon (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2141;
Treatment of MC varies based on severity, but medical therapy (e.g., budesonide) remains first-line with surgical intervention reserved for refractory cases. Figure: Focal intramucosal carcinoma arising from a tubulovillous adenoma in the ascending colon is shown in A. Cells in the transverse colon with abundant cytoplasm, marked atypia, and prominent nucleoli consistent with metastatic serous carcinoma are shown in B. Colonic mucosa with moderate chronic inflammation with lymphocytosis and lymphoid aggregates compatible with microscopic/lymphocytic colitis is shown in C. Nodular rectum is shown in D, the transverse colon mass-like lesion is shown in E, and the ascending colon mass-like lesion is shown in F.
- |||||||||| budesonide / Generic mfg.
Neither One nor the Other: Lymphocytic Enterocolitis as the Cause of Chronic Diarrhea (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_2129;
Given histologic findings patient was treated with budesonide and achieved complete resolution of his symptoms...Literature review describes similar cases of patients with a sprue that is refractory to gluten free diet and that have been subsequently found with both upper and lower GI lymphocytic infiltrates. This condition has been termed lymphocytic
- |||||||||| Dupixent (dupilumab) / Sanofi, Regeneron
Beyond the Esophagus: Dupilumab (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1889;
Despite continuing with budesonide slurry and PPI, repeat EGD showed persistent gastric ulcer for over the next 6 years...Figure: Fig 1a: EGD showing patient's gastric ulcer, indicated by yellow arrow, upon initial discovery. Fig 1b: EGD showing patient's gastric ulcer, indicated by yellow arrow, after 6 months of dupilumab treatment.
- |||||||||| Development of Celiac Disease After Immunotherapy for Psoriasis, Breast Cancer, and Renal Cell Carcinoma: A Case Series (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1756;
Case Description/ A 21 year old female with psoriasis on ixekizumab (IL-17A antagonist) and recent dose of risankizumab (IL-23A antibody) presented with abdominal pain, diarrhea, and bloating...Colonoscopy showed lymphocytic colitis, and she started budesonide and gluten free diet with some improvement...A 49 year old female with invasive ductal carcinoma was treated with leuprolide, exemestane, trastuzumab and pertuzumab (anti-HER2 antibodies) and developed severe watery diarrhea requiring hospitalization for electrolyte abnormalities and total parenteral nutrition...An 82 year old male with metastatic renal cell carcinoma was treated with axitinib, complicated by diarrhea requiring dose reduction, and pembrolizumab, discontinued due to colitis requiring prednisone, then cabozantinib, complicated by diarrhea which persisted after dose reduction...Figure: Figure: Duodenal Biopsy of Case 3, Celiac Disease in an 82 year old male with metastatic renal cell carcinoma treated with axitinib, pembrolizumab, and cabozantinib. (A) Routine H&E staining of a duodenal biopsy showed subtotal to total villous atrophy, (B) Duodenal biopsy with thickened sub-epithelial collagen layer highlighted on trichrome stain, (C) Duodenal biopsy with intraepithelial lymphocytosis confirmed by CD3 immunohistochemistry Table: Immunotherapies and Presentations of Celiac Disease
- |||||||||| budesonide / Generic mfg., albendazole / Generic mfg., acetylcysteine solution / Generic mfg.
Is It Safe to Take Your Dog (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1602;
N-acetylcysteine was empirically started...A liver biopsy was performed, and budesonide was started...Albendazole which is commonly used in humans has been associated with LFT elevation and even acute liver failure and death...Our patient exhibited a hepatocellular injury pattern with improvement upon fenbendazole discontinuation and lack of other identifiable causes of liver injury. Figure: Liver biopsy demonstrating pathologic features consistent with Severe Drug-Induced Liver Injury (A) Zone 3-predominant (centrilobular) collapse with hepatocyte dropout (B) Central Vein (C) Acidophil bodies (D) Portal triads with lymphocyte-predominant inflammatory infiltrates
- |||||||||| budesonide / Generic mfg.
A Rare Case of Non-Cirrhotic Portal Hypertension Caused by Necrobiotic Xanthogranuloma (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_1556;
The most common causes of NCPH is chronic infections, medications, thrombophilia, autoimmune disorders, and genetic disorders. NXG should remain on the differential for patients with NCPH without a known cause, as half cases of NCPH do not have a formal diagnosis to account for the patient
- |||||||||| budesonide / Generic mfg.
Journal: Budesonide Analogues Preserve Stem Cell Pluripotency and Delay 3D Gastruloid Development. (Pubmed Central) - Jul 29, 2023
Here we tested the effect of different budesonide derivatives and identified CHD-030498 as a more effective analogue of budesonide. CHD-030498 was able to prevent stem cell pluripotency exit in different cell-based models, including embryonic stem-to-mesenchymal transition, spontaneous differentiation and 3D gastruloid development, and at lower doses compared to budesonide.
- |||||||||| cyclophosphamide / Generic mfg., budesonide / Generic mfg.
Therapeutic Dilemmas in Glomerular Diseases (Room 204, Pennsylvania Convention Center) - Jul 15, 2023 - Abstract #KIDNEYWEEK2023KIDNEY_WEEK_43;
This session covers selected topics in the treatment of glomerular diseases in which there is a level of uncertainty regarding appropriate therapy. Learning Objective(s) Summarize the use of corticosteroids in IgA nephropathy, including delayed release formulation of budesonide Describe appropriate use of combination cyclophosphamide and corticosteroids in primary membranous nephropathy Discuss appropriate therapy for steroid-resistant primary FSGS Explain the role of adding SGLT2 inhibitors in the treatment of primary glomerular diseases
- |||||||||| Journal: Table: Some drug interactions with drugs for IBD. (Pubmed Central) - Jul 11, 2023
Learning Objective(s) Summarize the use of corticosteroids in IgA nephropathy, including delayed release formulation of budesonide Describe appropriate use of combination cyclophosphamide and corticosteroids in primary membranous nephropathy Discuss appropriate therapy for steroid-resistant primary FSGS Explain the role of adding SGLT2 inhibitors in the treatment of primary glomerular diseases No abstract available
- |||||||||| budesonide / Generic mfg.
Clinical, Retrospective data, Review: Effectiveness of Non-Budesonide Therapies in Management of Microscopic Colitis: A Systematic Review and Meta-analysis. (Pubmed Central) - Jul 7, 2023
No abstract available We performed a systematic review and meta-analysis to determine the effectiveness of non-budesonide therapies (thiopurines, bismuth subsalicylate [BSS], bile acid sequestrants [BAS], loperamide and biologics) for MC suggested by international guidelines...Treatment with tumor necrosis factor (TNF) inhibitors (infliximab and adalimumab) demonstrated a response rate of 73% (95% CI 0.63-0.83; I
- |||||||||| clobetasol propionate topical / Generic mfg., budesonide / Generic mfg.
Contact sensitization in atopic dermatitis: a prospective study of 84 patients () - Jul 3, 2023 - Abstract #WCD2023WCD_4907;
They are particularly at risk of contact sensitization to metals and allergens contained in topical treatments. We observed a high frequency of ACD to textile dyes, which to our knowledge was not previously reported.
- |||||||||| hydroxychloroquine / Generic mfg., budesonide / Generic mfg.
Journal: Novel agents for treating IgA nephropathy. (Pubmed Central) - Jun 29, 2023
We observed a high frequency of ACD to textile dyes, which to our knowledge was not previously reported. In recent years, IgAN has become the focus of a considerable number of clinical studies that will significantly advance the development of new therapy strategies.
- |||||||||| Biomarker, Review, Journal: Pharmacogenetic Testing for the Pediatric Gastroenterologist: Actionable Drug-Gene Pairs to Know. (Pubmed Central) - Jun 28, 2023
Our goal is to provide a practical tutorial on the currently available pharmacogenetic testing options and a results interpretation for drug-gene pairs important to medications commonly used in pediatric gastroenterology. We focus on evidence-based clinical guidelines published by the Clinical Pharmacogenetics Implementation Consortium (CPIC) to highlight relevant drug-gene pairs, including proton pump inhibitors and selective serotonin reuptake inhibitors and cytochrome P450 (CYP) 2C19, ondansetron and CYP2D6, 6-mercaptopurine and TMPT and Nudix hydrolase 15 (NUDT15), and budesonide and tacrolimus and CYP3A5.
- |||||||||| budesonide / Generic mfg.
Review, Journal: IgA Nephropathy: Current Treatment and New Insights. (Pubmed Central) - Jun 27, 2023
A better understanding of the pathophysiology of IgAN in recent years has led to the development of several new therapeutic agents. In this review, we summarize the current therapeutic approach for patients with IgAN as well as all novel investigational agents.
- |||||||||| budesonide / Generic mfg.
Journal: Contact allergy to corticosteroids: Is the European baseline series sufficient? (Pubmed Central) - Jun 16, 2023
Budesonide, hydrocortisone-17-butyrate, and tixocortol-21-pivalate in combination are sensitive corticosteroid markers. In case of clinical suspicion of corticosteroid contact allergy, patch testing with supplementary corticosteroids is highly recommended.
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