Oral budesonide for induction of remission in ulcerative colitis

Cochrane Database of Systematic Reviews

Volumn 2015, Issue 10, 2015, Pages

  Sherlock, Mary E ^a   Macdonald, John K ^b   Griffiths, Anne Marie ^c   Steinhart, A Hillary ^d   Seow, Cynthia H ^e  

^a MCMASTER CHILDREN S HOSPITAL   (Canada)

^b ROBARTS RESEARCH INSTITUTE   (Canada)

^c HOSPITAL FOR SICK CHILDREN   (Canada)

^d MOUNT SINAI HOSPITAL   (Canada)

^e UNIVERSITY OF CALGARY   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

BALSALAZIDE; BUDESONIDE; HYDROCORTISONE; MESALAZINE; OLSALAZINE; PLACEBO; PREDNISOLONE; SALAZOSULFAPYRIDINE; TRIACYLGLYCEROL LIPASE; ANTIINFLAMMATORY AGENT; NONSTEROID ANTIINFLAMMATORY AGENT; PREDNISONE;

ABDOMINAL PAIN; ACUTE APPENDICITIS; BACKACHE; CHOLESTASIS; CONSTIPATION; DIARRHEA; DISEASE EXACERBATION; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG SAFETY; DRUG WITHDRAWAL; DYSPEPSIA; EVENING DOSAGE; FEVER; FLATULENCE; GASTROINTESTINAL ENDOSCOPY; HEADACHE; HUMAN; HYDROCORTISONE BLOOD LEVEL; INSOMNIA; MORNING DOSAGE; NAUSEA; PRIORITY JOURNAL; REMISSION; REVIEW; RHINOPHARYNGITIS; SIDE EFFECT; SYSTEMATIC REVIEW; TREATMENT OUTCOME; TRIACYLGLYCEROL LIPASE BLOOD LEVEL; ULCERATIVE COLITIS; UNSPECIFIED SIDE EFFECT; COLITIS, ULCERATIVE; INDUCTION CHEMOTHERAPY; META ANALYSIS; ORAL DRUG ADMINISTRATION; PROCEDURES; RANDOMIZED CONTROLLED TRIAL (TOPIC);

ADMINISTRATION, ORAL; ANTI-INFLAMMATORY AGENTS; ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL; BUDESONIDE; COLITIS, ULCERATIVE; HUMANS; INDUCTION CHEMOTHERAPY; MESALAMINE; PREDNISONE; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 84979854789     PISSN: None     EISSN: 1469493X     Source Type: Journal    
DOI: 10.1002/14651858.CD007698.pub3     Document Type: Review

References (93)

1. D'Haens G, Kovács Á, Vergauwe P, Lonovics J, Bouhnik Y, Weiss W, et al. Safety and efficacy of a novel extended release budesonide formulation in patients with active left-sided ulcerative colitis. Gastroenterology 2007;132(4 Suppl 2):A505-6.
2. D'Haens GR, Kovács Á, Vergauwe P, Nagy F, Molnár T, Bouhnik Y, et al. Clinical trial: Preliminary efficacy and safety study of a new budesonide-MMX® 9 mg extended-release tablets in patients with active left-sided ulcerative colitis. Journal of Crohn's and Colitis 2010;4(2):153-60.
3. Gross V, Buganic I, Belousova EA, Mikhailova TL, Kupcinkas L, Kiudelis G, et al. 3g mesalazine granules are superior to 9mg budesonide for achieving remission in active ulcerative colitis: A double-blind, double-dummy, randomised trial. Journal of Crohn's and Colitis 2011;5(2):129-138.
4. Gross V, Bunganic I, Mikhailova TL, Kupcinskas L, Kiudelis G, Tulassay Z, et al. Efficacy and tolerability of a once daily treatment with budesonide capsules versus mesalamine granules for the treatment of active ulcerative colitis: A randomized, double-blind, double-dummy, multicenter study. Gastroenterology 2009;136(5 Suppl 1):A15.
5. Löfberg R, Danielsson Å, Suhr O, Nilsson Å, Schiöler R, Nyberg A, et al. Oral budesonide versus prednisone in patients with active extensive and left-sided ulcerative colitis. Gastroenterology 1996;110(6):1713-8.
6. Rubin D, Cohen R, Sandborn W, Lichtenstein G, Axler J, Riddell R, et al. Budesonide MMX 9 mg for inducing remission in patients with mild-to-moderate ulcerative colitis not adequately controlled with oral 5-asas. Inflammatory Bowel Diseases 2014;20(Suppl 1):S1.
7. Sandborn WJ, Travis S, Moro L, Ballard ED, Yeung P, Bleker W, et al. Budesonide Mxx 9mg for the induction of remission of mild-to-moderate ulcerative colitis (UC): Data from a multicenter, randomized, double-blind placebo-controlled study in North America and India. Gastroenterology 2011;140(5 Suppl 1):S124.
8. Sandborn WJ, Travis S, Moro L, Jones R, Gautille T, Bagin R, et al. Once-daily Budesonide MMX® extended-release tablets induce remission in patients with mild to moderate ulcerative colitis: Results from the CORE 1 study. Gastroenterology 2012;143(5):1218-26.
9. Sandborn WJ, Travis S, Danese S, Kupcinskas L, Alexeeva O, Moro L, et al. Budesonide-MMx 9 mg for induction of remission of mild-to-moderate ulcerative colitis (UC): Data from a multicenter, randomized, double-blind placebo-controlled study in the Europe, Russia, Israel and Australia. Gastroenterology 2011;140(5 Suppl 1):S65.
10. Travis S, Danese S, Kupcinskas L, Alexeeva O, D'Haens G, Gibson PR, et al. Once-daily budesonide MMX in active mild-to-moderate ulcerative colitis: results from the randomised CORE II study. Gut 2014;63(3):433-41.
11. Chopra A, Pardi DS, Loftus EV Jr, Tremaine WJ, Egan LJ, Faubion WA, et al. Budesonide in the treatment of inflammatory bowel disease: the first year of experience in clinical practice. Inflammatory Bowel Diseases 2006;12(1):29-32.
12. Danese S, Kupcinskas L, Ballard ED, Harris-Collazo R, Haridman Y, Huang M, Travis SP. Budesonide MMX® efficacy is independent of previous mesalazine exposure in ulcerative colitis: pooled analysis of CORE I and CORE II. United European Gastroenterology Journal 2013;1(1 Suppl):OP262.
13. Días Blasco J, Robledo Andrés P. Advances in the topical steroid treatment of inflammatory bowel disease [Avances en el tratamiento esteroideo tópico de la enfermedad inflamatoria intestinal]. Revista Española de Enfermedades Digestivas 1995;87(11):802-7.
14. Feagan B. Budesonide therapy for ulcerative colitis: a topical tale. Gastroenterology 1996;110(6):2000-17.
15. Fedorak RN, Bistritz L. Targeted delivery, safety, and efficacy of oral enteric-coated formulations of budesonide. Advanced Drug Delivery Reviews 2005;57(2):303-16.
16. Gomollón F, Hinojosa J, Nos P. Budesonide and inflammatory bowel disease [Budesonida y enfermedad inflamatoria intestinal]. Gastroenterología y Hepatología 1999;22(10):525-32.
17. Keller R, Stoll R, Foerster EC, Gutsche N, Domschke W. Oral budesonide therapy for steroid-dependent ulcerative colitis. Alimentary Pharmacology and Therapeutics 1997;11(6):1047-52.
18. Kolkman JJ, Möllmann HW, Möllmann AC, Peńa AS, Greinwald R, Tauschel HD, et al. Evaluation of oral budesonide in the treatment of active distal ulcerative colitis. Drugs of Today 2004;40(7):589-601.
19. Kolkman JJ, Mölmann HW, Möllman AC, Nelis FG, Viergever P, Peña S. Beneficial effect of oral budesonide for distal ulcerative colitis: A comparative study of Budenfalk® 3 MG TID VS 9 MG OD. Gastroenterology 2000;118(4 Suppl 2):A779.
20. Lamers CB, Wagtmans MJ, Van Der Sluys Veer A, Van Hogezand RA, Griffioen G. Budesonide in inflammatory bowel disease. Netherlands Journal of Medicine 1996;48(2):60-3.
21. Lichtenstein GR, Danese S, Ballard ED, Moro L, Jones RJ, Bagin R, et al. Effect of budesonide MMX 6 mg on the hypothalamic-pituitary-adrenal (HPA) axis in patients with ulcerative colitis: Results from a phase III, 12 month safety and extended use study. Gastroenterology 2012;142(5 Suppl 1):S785.
22. Lichtenstein G, Sandborn W, Huang M, Hardiman Y, Bagin R, Yeung P, et al. Budesonide MMX versus placebo in patients with active, mild-to-moderate ulcerative colitis who were 5-ASA naive or previously treated with 5-ASA. Inflammatory Bowel Diseases 2013;19:S83.
23. Lichtenstein GR, Sandborn W, Huang M, Hardiman Y, Bagin R, Yeung P, et al. Budesonide MMX 9 mg induces remission in mild-to-moderately active UC patients regardless of prior history of 5-ASA therapy. Gastroenterology 2013;144(5 Suppl 1):S234.
24. Marín-Jiménez I, Peña AS. Budesonide for ulcerative colitis. Revista Española de Enfermedades Digestivas 2006;98(5):362-73.
25. Sandborn W, Bagin R, Zhao J, Huang M, Hardiman Y, Schulteis C, et al. Symptom resolution and clinical and endoscopic remission both resulted in improved quality of life in patients with ulcerative colitis. Inflammatory Bowel Diseases 2013;19:S82.
26. Sandborn W, Hardiman Y, Huang M, Harris-Collazo R, Ballard ED, Travis S. Efficacy of budesonide MMX in reduction of symptoms in patients with mild-to-moderately active ulcerative colitis: A pooled analysis of the core I and core II studies. Gastroenterology 2013;144(5 Suppl 1):S233-4.
27. Sandborn W, Travis S, Bala N, Danese S, Moro L, Ballard ED, et al. Induction of clinical and endoscopic remission of mild to moderately active ulcerative colitis with budesonide MMX 9 MG: Analysis of pooled data from two phase 3 studies. American Journal of Gastroenterology 2011;106:S485.
28. Sandborn WJ, Danese S, D'Haens G, Moro L, Jones R, Bagin R, et al. Induction of clinical and colonoscopic remission of mild-to-moderate ulcerative colitis with budesonide MMX 9 mg: pooled analysis of two phase 3 studies. Alimentary Pharmacology and Therapeutics 2015;41(5):409-18.
29. Silverman J, Otley A. Budesonide in the treatment of inflammatory bowel disease. Expert Review of Clinical Immunology 2011;7(4):419-28.
30. Travis S, Ballard ED II, Bagin B, Gautille T, Huang M. Induction of remission with oral budesonide MMXVR (9 mg) tablets in patients with mild to moderate, active ulcerative colitis: A multicenter, open-label efficacy and safety study. Inflammatory Bowel Diseases 2011;17(Suppl 2):S20.
31. Travis S, Danese S, Moro L, Ballard ED, Bagin R, Gautille T, et al. Induction of clinical and endoscopic remission with budesonide MMX in mild to moderately active ulcerative colitis: Pooled data from two phase 3 studies. Journal of Crohn's and Colitis 2012;6:S74.
32. Bar-Meir S, Fidder HH, Faszczyk M, Bianchi Porro G, Sturniolo GC, Mickisch O, et al. Budesonide foam vs. hydrocortisone acetate foam in the treatment of active ulcerative proctosigmoiditis. Diseases of the Colon and Rectum 2003;46(7):929-36.
33. Barnes PJ. Molecular mechanisms and cellular effects of glucocorticosteroids. Immunology and allergy clinics of North America 2005;25(3):451-68.
34. Baumgart DC, Sandborn WJ. Inflammatory bowel disease: clinical aspects and established and evolving therapies. Lancet 2007;369(9573):1641-57.
35. Beattie RM, Nicholls SW, Domizio P, Williams CB, Walker-Smith JA. Endoscopic assessment of the colonic response to corticosteroids in children with ulcerative colitis. Journal of Pediatric Gastroenterology and Nutrition 1996;22(4):373-9.
36. Biancone L, Michetti P, Travis S, Escher J, Moser G, Forbes A, et al. European evidence-based consensus on the management of ulcerative colitis: special situations. Journal of Crohn's and Colitis 2008;2(1):63-92.
37. Bickston SJ, Behm BW, Tsoulis DJ, Cheng J, MacDonald JK, Khanna R, Feagan BG. Vedolizumab for induction and maintenance of remission in ulcerative colitis. Cochrane Database of Systematic Reviews 2014, Issue 8. [DOI: 10.1002/14651858.CD007571.pub2]
38. Cohen RD, Woseth DM, Thisted RA, Hanauer SB. A meta-analysis and overview of the literature on treatment options for left-sided ulcerative colitis and ulcerative proctitis. American Journal of Gastroenterology 2000;95(5):1263-76.
39. Danese S, Siegel CA, Peyrin-Biroulet L. Review article: integrating budesonide-MMX into treatment algorithms for mild-to-moderate ulcerative colitis. Alimentary Pharmacology and Therapeutics 2014;39(10):1095-103.
40. Danielsson A, Löfberg R, Persson T, Salde L, Schiöler R, Suhr O, Willén R. A steroid enema, budesonide, lacking systemic effects for the treatment of distal ulcerative colitis or proctitis. Scandinavian Journal of Gastroenterology 1992;27(1):9-12.
41. De Cassan C, Fiorino G, Danese S. Second-generation corticosteroids for the treatment of Crohn's disease and ulcerative colitis: more effective and less side effects?. Digestive Diseases 2012;30(4):368-75.
42. Dignass A, Lindsay JO, Sturm A, Windsor A, Colombet LF, Allez M, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. Journal of Crohn's and Colitis 2012;6(10):991-1030.
43. Dilger K, Schwab M, Fromm MF. Identification of budesonide and prednisone as substrates of the intestinal drug efflux pump P-glycoprotein. Inflammatory Bowel Diseases 2004;10(5):578-83.
44. Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 2001;48(4):526-35.
45. Ekbom A, Helmick C, Zack M, Adami HO. Ulcerative colitis and colorectal cancer. A population-based study. New England Journal of Medicine 1990;323(18):1228-33.
46. Feagan BG, Rutgeerts P, Sands BE, Hanauer S, Colombel JF, Sandborn WJ, et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. New England Journal of Medicine 2013;369(8):699-710.
47. Ford AC, Bernstein CN, Khan KJ, Abreu MT, Marshall JK, Takkey NJ, Moayyedi P. Glucocorticosteroid therapy and inflammatory bowel disease: a systematic review and meta-analysis. American Journal of Gastroenterology 2011;106(4):590-9.
48. Gionchetti P, Praticò C, Rizzello F, Calafiore A, Capozzi N, Campieri M, Calabrese C. The role of budesonide-MMX in active ulcerative colitis. Expert Review of Gastroenterology and Hepatology 2014;8(3):215-22.
49. Griffiths AM. Specificities of inflammatory bowel disease in childhood. Best Practice and Research. Clinical Gastroenterology 2004;18(3):509-23.
50. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924-6.
51. Hanauer S, Schwartz J, Robinson M, Roufail W, Arora S, Cello J, et al. Mesalamine capsules for the treatment of active ulcerative colitis: results of a controlled trial. Pentasa Study Group. American Journal of Gastroenterology 1993;88(8):1188-97.
52. Hanauer SB. Inflammatory bowel disease: epidemiology, pathogenesis, and therapeutic opportunities. Inflammatory Bowel Diseases 2006;12 Suppl 1:S3-9.
53. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327(7414):557-60.
54. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
55. Hoy SM. Budesonide MMX(®): a review of its use in patients with mild to moderate ulcerative colitis. Drugs 2015;75(8):879-86.
56. Itzkowitz SH, Yio X. Colorectal cancer in inflammatory bowel disease: the role of inflammation. American Journal of Physiology. Gastrointestinal and Liver Physiology 2004;287(1):G7-17.
57. Jönsson G, Aström A, Andersson P. Budesonide is metabolized by cytochrome P450 3A (CYP3A) enzymes in human liver. Drug Metabolism and Disposition: The Biological Fate of Chemicals 1995;23(1):137-42.
58. Kirsner JB. Historical origins of current IBD concepts. World Journal of Gastroenterology 2001;7(2):175-84.
59. Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. American Journal of Gastroenterology 2010;105(3):501-23.
60. Kozuch PL, Hanauer SB. Treatment of inflammatory bowel disease: a review of medical therapy. World Journal of Gastroenterology 2008;14(3):354-77.
61. Kucharzik T, Maaser C, Lügering A, Kagnoff M, Mayer L, Targan S, et al. Recent understanding of IBD pathogenesis: implications for future therapies. Inflammatory Bowel Diseases 2006;12(11):1068-83.
62. Kuenzig ME, Rezaie A, Seow CH, Otley AR, Steinhart AH, Griffiths AM, Kaplan GG, Benchimol EI. Budesonide for maintenance of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2014, Issue 8. [DOI: 10.1002/14651858.CD002913.pub3]
63. Lakatos L, Mester G, Erdelyi Z, David G, Pandur T, Balogh M, et al. Risk factors for ulcerative colitis-associated colorectal cancer in a Hungarian cohort of patients with ulcerative colitis: results of a population-based study. Inflammatory Bowel Diseases 2006;12(3):205-11.
64. Lawson MM, Thomas AG, Akobeng AK. Tumour necrosis factor alpha blocking agents for induction of remission in ulcerative colitis. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD005112.pub2]
65. Lichtenstein GR, Abreu MT, Cohen R, Tremaine W, American Gastroenterological Association. American Gastroenterological Association Institute technical review on corticosteroids, immunomodulators, and infliximab in inflammatory bowel disease. Gastroenterology 2006;130(3):940-87.
66. Lichtenstein GR, Bengtsson B, Hapten-White L, Rutgeerts P. Oral budesonide for maintenance of remission of Crohn's disease: a pooled safety analysis. Alimentary Pharmacology and Therapeutics 2009;29(6):643-53.
67. Lichtiger S, Present DH. Preliminary report: cyclosporin in treatment of severe active ulcerative colitis. Lancet 1990;336(8706):16-9.
68. Lockhart-Mummery HE, Morson BC. Crohn's disease (regional enteritis) of the large intestine and its distinction from ulcerative colitis. Gut 1960;1:87-105.
69. Nos P, Hinojosa J. Gomollón F, Ponce J. Budesonide in inflammatory bowel disease: a meta-analysis [Metaanálisis sobre la efectividad de la budesonida en la enfermedad inflamatoria intestinal]. Medicina Clínica 2001;116(2):47-53.
70. Powell-Tuck J, Bown RL, Lennard-Jones JE. A comparison of oral prednisolone given as single or multiple daily doses for active proctocolitis. Scandinavian Journal of Gastroenterology 1978;13(7):833-7.
71. Rachmilewitz D. Coated mesalamine (5-aminosalicylic acid) versus sulphasalazine in active ulcerative colitis: a randomised trial. BMJ 1989;298(6666):82-6.
72. Rezaie A, Kuenzig ME, Benchimol EI, Griffiths AM, Otley AR, Steinhart AH, Kaplan GG, Seow CH. Budesonide for induction of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2015, Issue 6. [DOI: 10.1002/14651858.CD000296.pub4]
73. Riley SA, Mani V, Goodman MJ, Dutt S, Herd ME. Microscopic activity in ulcerative colitis: what does it mean?. Gut 1991;32(2):174-8.
74. Rutgeerts P, Sandborn WJ, Feagan BG, Reinisch W, Olson A, Johanns J, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. New England Journal of Medicine 2005;353(23):2462-76.
75. Rutter M, Saunders B, Wilkinson K, Rumbles S, Schofield G, Kamm M, et al. Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenterology 2004;126(2):451-9.
76. Sabate JM, Chaussade S. Modalities of corticosteroid therapy in inflammatory bowel disease [Modalités de la corticothérapie au cours des maladies inflammatoires du tube digestif]. Semaine des Hôpitaux de Paris 1998;74:1079-89.
77. Sands BE. Inflammatory bowel disease: past, present, and future. Journal of Gastroenterolgy 2007;42(1):16-25.
78. Saverymuttu SH, Camilleri M, Rees H, Lavender JP, Hodgson HJ, Chadwick VS. Indium 111-granulocyte scanning in the assessment of disease extent and disease activity in inflammatory bowel disease. A comparison with colonoscopy, histology, and fecal indium 111-graunlocyte excretion. Gastroenterology 1986;90(5 Pt 1):1121-8.
79. Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. New England Journal of Medicine 1987;317(26):1625-9.
80. Schünemann HJ, Oxman AD, Vist GE, Higgins JPT, Deeks JJ, Glasziou P, et al. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
81. Seo M, Okada M, Yao T, Ueki M, Arima A, Okumura M. An index of disease activity in patients with ulcerative colitis. American Journal of Gastroenterology 1992;87(8):971-6.
82. Seow CH, Benchimol EI, Steinhart AH, Griffiths AM, Otley AR. Budesonide for Crohn's disease. Expert Opinion on Drug Metabolism and Toxicology 2009;5(8):971-9.
83. Sutherland LR, Martin F, Greer S, Robinson M, Greenberger N, Saibil F, et al. 5-Aminosalicylic acid enema in the treatment of distal ulcerative colitis, proctosigmoiditis and proctitis. Gastroenterology 1987;92(6):1894-8.
84. Thomsen OO, Cortot A, Jewell D, Wright JP, Winter T, Veloso FT, et al. A comparison of budesonide and mesalamine for active Crohn's disease. International Budesonide-Mesalamine Study Group. New England Journal of Medicine 1998;339(6):370-4.
85. Timmer A, McDonald JW, Tsoulis DJ, MacDonald JK. Azathioprine and 6-mercaptopurine for maintenance of remission in ulcerative colitis. Cochrane Database of Systematic Reviews 2012, Issue 9. [DOI: 10.1002/14651858.CD000478.pub3]
86. Travis SP. Review article: induction therapy for patients with active ulcerative colitis. Alimentary Pharmacology and Therapeutics 2006;24(s1):10-6.
87. Travis SP, Schnell D, Krzeski P, Abreu MT, Altman DG, Colombel JF, et al. Developing an instrument to assess the endoscopic severity of ulcerative colitis: the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Gut 2012;61(4):535-42.
88. Truelove SC, Witts LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. British Medical Journal 1955;2(4947):1041-8.
89. Turner D, Otley AR, Mack D, Hyams J, de Bruijne J, Uusoue K, et al. Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study. Gastroenterology 2007;133(2):423-32.
90. Van Limbergen J, Russell RK, Drummond HE, Aldhous MC, Round NK, Nimmo ER, et al. Definition of the phenotypic characteristics of childhood-onset inflammatory bowel disease. Gastroenterology 2008;135(4):1114-22.
91. Walmsley RS, Ayres RC, Pounder RE, Allan RN. A simple clinical colitis activity index. Gut 1998;43(1):29-32.
92. Xavier RJ, Podolsky DK. Unravelling the pathogenesis of inflammatory bowel disease. Nature 2007;448(7152):427-34.
93. Sherlock ME, Seow CH, Steinhart HS. Griffiths AM. Oral budesonide for induction of remission in ulcerative colitis. Cochrane Database of Systematic Reviews 2010, Issue 10. [DOI: 10.1002/14651858.CD007698.pub2]