Everything old is new again? A fresh look at corticosteroids in ulcerative colitis

Am J Gastroenterol. 2008 Oct;103(10):2517-8. doi: 10.1111/j.1572-0241.2008.02112.x.

Abstract

Corticosteroid therapy remains a mainstay in the treatment of active ulcerative colitis. While useful in the induction of remission, corticosteroids should be avoided for maintenance therapy because of lack of efficacy and serious short- and long-term side effects. Bone fracture risk is increased with as little as 3 months of therapy so that safer corticosteroid therapies would have a significant impact. In this issue of American Journal of Gastroenterology, the treatment of mild to moderate ulcerative colitis with dexamethasone 21-P encapsulated erthryocytes (DEE), a novel method of corticosteroid drug delivery, is described. The results suggest similar efficacy as conventional oral corticosteroids with significantly decreased short-term corticosteroid-related side effects. This study was small and follow-up was limited, but the findings are intriguing. These results should prompt further study of this method of drug delivery to confirm efficacy, assess short-term and possibly long-term side effect, and determine whether this translates into better overall safety.

Publication types

  • Comment
  • Editorial

MeSH terms

  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / drug therapy*
  • Dexamethasone / administration & dosage
  • Dexamethasone / pharmacokinetics
  • Drug Carriers / administration & dosage*
  • Erythrocytes*
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / pharmacokinetics
  • Humans
  • Infusions, Intravenous
  • Treatment Outcome

Substances

  • Drug Carriers
  • Glucocorticoids
  • Dexamethasone