New data on inflammatory bowel disease treatment with topical steroids

Glucocorticosteroids (GCSs) remain the mainstay primary treatment of active inflammatory bowel disease (IBD). These agents usually result in a rapid suppression of symptoms but due to the ubiquitous nature of the GCS receptor, they also cause systemic side-effects. Recently, new, GCSs developed mainly for asthma (eg., budesonide) have been found to counter the problem of systemic side-effects due to a greater first-pass metabolism and an increased affinity for the GCS receptor, resulting in a predominantly topical mode of action. Budesonide seems particularly suitable for IBD conditions. It has been developed for both rectal and oral delivery to the gut and has been shown to have good efficacy in both Crohn's disease and ulcerative colitis with a mild side-effect profile.