Long-term use of budesonide in microscopic colitis (MC) appears to be effective, according to a recent study published in The American Journal of Gastroenterology

The outcomes and safety of budesonide maintenance therapy in microscopic colitis (MC) are not well known. Adult residents of Olmsted County, Minnesota diagnosed with MC (2002-2019) and treated with budesonide were identified using the Rochester Epidemiology Project. The response was assessed at 12 +/- 4 weeks after initiation of therapy and defined as complete (resolution of diarrhoea), partial (≥50% improvement in a number of bowel movements), nonresponse (<50% improvement), and intolerance (discontinued due to side-effects). For safety outcomes, cases (budesonide maintenance) and MC controls (no budesonide therapy) were matched by gender and age at diagnosis (+/-2 years).

The results of the study are:
A total of 450 patients were identified, of which 162 (36.0%) were treated with budesonide for induction of clinical remission
Clinical outcomes for induction were as follows: 130 (80.2%) complete response, 22 (13.6%) partial response, 8 (4.9%) no response, and 2 (1.2%) intolerance. After induction, 96 (63.2%) had recurrence after discontinuation; 27 (28.1%) required further budesonide induction treatment without maintenance, 56 (58.3%) required long-term budesonide maintenance, and 13 (13.5%) were treated with other therapies.
Of those receiving budesonide maintenance, all responded [55 (98.2%) complete, 1 (1.8%) partial].
No patient stopped maintenance from adverse events. The median duration of follow-up was 5.6 years (0.3-18.9).
There was no significant difference between cases and controls in the incidence of osteopenia/ osteoporosis, diabetes mellitus, hypertension, glaucoma, or cataracts.
Thus, the long-term use of budesonide in MC appears to be effective and generally well tolerated with limited adverse effects.
Reference:
Budesonide Maintenance in Microscopic Colitis: Clinical Outcomes and Safety Profile from a Population-Based Study by Tome, June et al. published in The American Journal of Gastroenterology.
doi: 10.14309/ajg.0000000000001774
Keywords:
Budesonide, Maintenance, Microscopic Colitis, Clinical Outcomes, Safety Profile, Population-Based Study, Tome, June Sehgal, Kanika Kamboj, Amrit K. Comstock, Bryce, Harmsen, William S. Khanna, Sahil, Pardi, Darrell S., The American Journal of Gastroenterology