ArticleDigestive diseases and sciences2024
Budesonide Induces Favourable Histologic and Symptomatic Recovery in Patients with Non-responsive and Refractory Coeliac Disease When Given in an Open Capsule Format.
Article in Digestive diseases and sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- European Society for the Study of Coeliac Disease (ESsCD) 2025 Updated Guidelines on the Diagnosis and Management of Coeliac Disease in Adults. Part 2: Management, Follow-Up, and Complex Disease Courses.United European gastroenterology journal · 2026Guideline
- Review
- Risk of malignancy and surveillance of premalignant gastrointestinal lesions in adult celiac disease.Frontiers in oncology · 2026Review
- A novel clustering of down syndrome and coeliac disease complicated by enteritis and small intestinal strictures: a case series.Therapeutic advances in gastroenterology · 2026Article
- Nutritional remission without mucosal healing in type II refractory celiac disease: a case report.Frontiers in nutrition · 2026Article
- Diagnosis and management of celiac disease.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Review
- Management Strategy for Non-Responsive and Refractory Celiac Disease in Adults: A Review Article.Journal of clinical medicine · 2025Review
- Oral Budesonide in Oncology: A Novel Approach to Managing Gastrointestinal Immune-Related Adverse Events.Current treatment options in oncology · 2025Review
- Refractory Celiac Disease: What the Gastroenterologist Should Know.International journal of molecular sciences · 2024Review
- Evolution in coeliac disease diagnosis and management.JGH open : an open access journal of gastroenterology and hepatology · 2024Review
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionNon-responsive coeliac disease (NRCD), where symptoms and enteropathy persist despite a prolonged gluten-free diet (GFD), is common. Refractory coeliac disease (RCD), characterised by malabsorption and extensive enteropathy, is rare but serious. In both, treatment options are limited. Topical budesonide may help and an open capsule format promoting proximal small intestinal delivery may be advantageous.
aimTo describe the effect of budesonide and its presentation on mucosal healing, symptoms, and tolerability in NRCD and RCD.
methodsA retrospective cohort study of NRCD and RCD patients who received budesonide for enteropathy despite a strict GFD for over 12 months. Primary outcome was improvement in histology. Symptoms and adverse treatment effects were recorded.
results50 patients with NRCD (n = 14; 86% F), RCD type 1 (n = 30; 60% F), and RCD type 2 (n = 6 based on aberrant duodenal T cells; 33% F) were identified. Common RCD symptoms were diarrhoea (68%), fatigue (40%), and weight loss (34%). 16 received closed capsule budesonide (CCB) 9 mg OD and 35 open capsule budesonide (OCB) 3 mg 3 times a day. Complete and partial mucosal healing was significantly higher after OCB compared to CCB (p < 0.001, Mann-Whitney U test). Symptom improvement was also significantly higher after OCB compared to CCB (p = 0.002, Mann-Whitney U test). Side effects were mild and self-limiting and were reported in 25% of both cohorts.
conclusionOCB was well tolerated and associated with improvements in enteropathy (83%) and symptoms (90%) in NRCD and RCD. Our findings support OCB as the preferred 1st-line therapy for NRCD and RCD type 1.
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