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Found 5 results

  1. Celiac.com 04/16/2019 - A team of researchers from the Celiac Center at Beth Israel Deaconess Medical Center highlighted the potential of an enteric-release, oral budesonide as a treatment for acute reactions to gluten exposure in patients with celiac disease. The research team included Amelie Therrien, MD MSc, Jocelyn A. Silvester, MD PhD, Daniel A. Leffler, MD MSc, Ciaran P. Kelly, MD. They are variously affiliated with the Celiac Center, Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston USA; the Celiac Research Program, Harvard Medical School, Boston USA; the Division of Gastroenterology, Hepatology and Nutrition, Boston Children Hospital, Boston USA; the Rady College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; and with Takeda Pharmaceutical International Co, Cambridge, USA. Celiac Center physician, Ciaran Kelly, MD, and colleagues wrote that inadvertent exposure to gluten is still common even though patients specifically try to avoid it. Researchers report on a group of consecutive celiac patients with acute gluten exposure, who were treated with enteric-related budesonide. The group included 12 patients with biopsy-confirmed celiac disease, and one patient with potential celiac disease — defined as normal duodenal histology, elevated tissue transglutaminase antibodies, HLADQ2.5 or DG8 positivity and clinical response to a gluten-free diet. Researchers measured patient-reported clinical response to budesonide, defined in terms of symptom severity and duration as “substantial,” “partial,” or, simply “response." The patients started budesonide therapy as soon as possible after gluten exposure and symptom onset. All patients reported a clinical response to the drug, with eight patients reporting "substantial" improvement of GI symptoms. The team makes clear that they do not "advocate steroid use for uncomplicated [celiac disease]." The team notes that they selected patients for the budesonide trial based on severe, debilitating gluten reactions, due to intermittent accidental gluten exposure" despite following a [gluten-free diet],” the team wrote. Though the study lacks objective endpoints and includes varying treatments, budesonide can help to relieve serious symptoms of gluten exposures in celiac patients, justifying both this, and future, clinical trials, according to Dr. Alex Young. As a disclosure, Dr. Kelley notes that he served as a scientific advisory to Cour Pharmaceuticals, Glutenostics, Innovate, ImmunogenX, and Takeda. He also acts as a principal investigator on research grants on celiac disease supported by Aptalis and Takeda. Please see the full study for all other authors’ relevant financial disclosures. Clin Gastroenterol Hepatol 2019. doi:10.1016/j.cgh.2019.03.029.
  2. Celiac.com 05/24/2017 - Refractory celiac disease (RCD) is a rare manifestation of celiac disease that is difficult to treat, and often results in death from enteropathy-associated T-cell lymphoma. Doctors looking to treat RCD have found very limited success with a number of immunosuppressive medications (IMs), including azathioprine, systemic corticosteroids, or regular budesonide. A team of researchers at the Mayo Clinic recently set out to assess open-capsule budesonide (OB) treatment on RCD patients, including those who saw no improvement with previous IM treatments. The research team included Saurabh S Mukewar, Ayush Sharma, Alberto Rubio-Tapia, Tsung-Teh Wu, Bana Jabri and Joseph A Murray. The team first looked for RCD patients treated with OB at Mayo Clinic, Rochester, Minnesota from 2003 to 2015. They then reviewed demographic, serologic, and clinical variables in these patients. The team found a total of 57 patients who received OB as treatment for suspected RCD. Based on clonal T-cell receptor gamma gene rearrangement or aberrant phenotype of intraepithelial lymphocytes (IELs), the team classified 13 patients (23%) as having RCD-2 and 43 (75%) as RCD-1. The team was unable to determine TCR gene rearrangement status for one patient (2%). Most patients were women (69%), with an average age of 60.5 (+/- 3.5) years, while average body mass index was 28.4 kg/m2. Nearly 75% of patients suffered from diarrhea, with an average of 6 bowel movements per day (range, 4–25). Nearly half of these patients failed to improve with IM treatment. Twenty-four patients (42%) were anemic, while 12 patients (21%) had hypoalbuminemia. Biopsies showed Marsh 3 lesions in all patients, broken down as follows: 19% were Marsh 3a, 46% were Marsh 3b, and 35% were Marsh 3c. After OB therapy, 92% showed clinical improvement, while 89% showed histologic improvement. Subsequent biopsies showed that 7 out of 13 patients with RCD-2 (53%) displayed an absence of the previously observed clonal TCR gamma gene rearrangement/aberrant IEL phenotype. During the follow-up period, two patients died of enteropathy-associated T-cell lymphoma. Most RCD patients show clinical and histopathologic improvement with OB treatment, including those who previously failed to respond to other IMs. These results show that treatment with open-capsule budesonide is a promising option for patients looking to manage RCD. Source: The American Journal of Gastroenterology, (21 March 2017). doi:10.1038/ajg.2017.71
  3. I saw my GI yesterday. He and I agreed to start me on Entocort EC/Budesonide medication. It is a slow release 3mg capsule that is not dissolved by the stomach pH and instead gets broken down and absorbed in the intestines. It is supposed to have a local effect versus systemic and is considered safer than prednisone. I will be on 9 mg dose once a day for 2 months then we will start to taper the dose down pending my symptoms and then wean off completely. Many have good results with the course of medication and then go into 'remission' for long periods of time. I am still planning on keeping my food diary to see if I can pin point any food groups that initiate flare ups. I have a nutritionist appointment in January as well. I am hoping things will improve with the medication. I have done a lot of reading and things look optimistic!
  4. Anyone else with celiac disease taking Budesonide (or Entocort)? Just started taking it and I'm itching like crazy similar to when I eat gluten. I checked the active and inactive ingredients but couldn't find any. Was curious if many other celiacs are using it.
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