Skip to main content
Erschienen in: International Journal of Colorectal Disease 4/2005

01.07.2005 | Original Article

Oral budesonide therapy improves quality of life in patients with collagenous colitis

verfasst von: Ahmed Madisch, Peter Heymer, Claudia Voss, Bernd Wigginghaus, Elke Bästlein, Ekkehard Bayerdörffer, Eberhard Meier, Wolfgang Schimming, Birgit Bethke, Manfred Stolte, Stephan Miehlke

Erschienen in: International Journal of Colorectal Disease | Ausgabe 4/2005

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Collagenous colitis is an idiopathic microscopic colitis characterised by watery diarrhoea. The impact of collagenous colitis on quality of life has not been assessed. Our aim was to assess quality of life in patients with this condition and compare the effect of treatment with budesonide capsules or placebo on this parameter.

Methods

Patients with chronic diarrhoea and histologically-proven collagenous colitis were randomised to receive either budesonide controlled-release capsules (Entocort capsules, AstraZeneca, Lund, Sweden), 9 mg/day, or placebo for 6 weeks. Quality of life was measured using the validated Gastrointestinal Quality of Life Index (GIQLI) at baseline and after 6 weeks. With the GIQLI, scores range from 0 to 144, with higher scores representing better quality of life.

Results

Complete quality of life assessment was available in 29 patients (budesonide: n=17; placebo: n=12). At baseline, quality of life was low in patients with collagenous colitis (mean 76). After 6 weeks of treatment, the mean GIQLI score increased significantly in the budesonide group (from 67 to 92, p<0.001), but remained unchanged in the placebo group (86–88). The mean score of the dimensions symptoms (p=0.001), emotional functioning (p=0.003) and physical functioning (p=0.017) increased significantly in the budesonide group compared with the placebo group. A significantly larger proportion of patients in the budesonide group experienced improved stool consistency (p<0.01) and a significant reduction in the mean stool frequency compared with those in the placebo group (p<0.01).

Conclusion

Quality of life is seriously reduced in patients with collagenous colitis. Six-week treatment with oral budesonide controlled-release capsules significantly improves quality of life and clinical symptoms compared with placebo in these patients.
Literatur
1.
Zurück zum Zitat Lindstrom CG (1976) ‘Collagenous colitis’ with watery diarrhea. A new entity. Pathol Eur 11:87–89PubMed Lindstrom CG (1976) ‘Collagenous colitis’ with watery diarrhea. A new entity. Pathol Eur 11:87–89PubMed
2.
Zurück zum Zitat Bohr J, Tysk C, Eriksson S et al (1996) Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients. Gut 39:846–851PubMed Bohr J, Tysk C, Eriksson S et al (1996) Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients. Gut 39:846–851PubMed
3.
Zurück zum Zitat Jessurun J, Yardley JH, Giardiello FM et al (1987) Chronic colitis with thickening of the subepithelial collagen layer (collagenous colitis): histopathological findings in 15 patients. Hum Pathol 18:839–848PubMed Jessurun J, Yardley JH, Giardiello FM et al (1987) Chronic colitis with thickening of the subepithelial collagen layer (collagenous colitis): histopathological findings in 15 patients. Hum Pathol 18:839–848PubMed
4.
Zurück zum Zitat Stolte M, Ritter M, Borchard F et al (1990) Collagenous gastroduodenitis and collagenous colitis. Endoscopy 22:186–187PubMed Stolte M, Ritter M, Borchard F et al (1990) Collagenous gastroduodenitis and collagenous colitis. Endoscopy 22:186–187PubMed
5.
Zurück zum Zitat Ayata G, Ithamukkala S, Sapp H et al (2002) Prevalence and significance of inflammatory bowel disease-like morphologic features in collagenous and lymphocytic colitis. Am J Surg Pathol 26:1414–1423CrossRefPubMed Ayata G, Ithamukkala S, Sapp H et al (2002) Prevalence and significance of inflammatory bowel disease-like morphologic features in collagenous and lymphocytic colitis. Am J Surg Pathol 26:1414–1423CrossRefPubMed
6.
Zurück zum Zitat Bürgel N, Bojarski C, Mankertz J et al (2002) Mechanisms of diarrhea in collagenous colitis. Gastroenterology 123:433–443CrossRefPubMed Bürgel N, Bojarski C, Mankertz J et al (2002) Mechanisms of diarrhea in collagenous colitis. Gastroenterology 123:433–443CrossRefPubMed
7.
Zurück zum Zitat Fernandez-Banares F, Salas A, Forne M et al (1999) Incidence of collagenous and lymphocytic colitis: a 5-year population-based study. Am J Gastroenterol 94:418–423CrossRefPubMed Fernandez-Banares F, Salas A, Forne M et al (1999) Incidence of collagenous and lymphocytic colitis: a 5-year population-based study. Am J Gastroenterol 94:418–423CrossRefPubMed
8.
Zurück zum Zitat Agnarsdottir M, Gunnlaugsson O, Orvar KB et al (2002) Collagenous and lymphocytic colitis in Iceland. Dig Dis Sci 47:1122–1128CrossRefPubMed Agnarsdottir M, Gunnlaugsson O, Orvar KB et al (2002) Collagenous and lymphocytic colitis in Iceland. Dig Dis Sci 47:1122–1128CrossRefPubMed
9.
Zurück zum Zitat McKeage K, Goa KL (2002) Budesonide (Entocort EC capsules). A review of its therapeutic use in the management of active Crohn’s disease in adults. Drugs 62:2263–2282PubMed McKeage K, Goa KL (2002) Budesonide (Entocort EC capsules). A review of its therapeutic use in the management of active Crohn’s disease in adults. Drugs 62:2263–2282PubMed
10.
Zurück zum Zitat Baert F, Schmit A, D’Haens G et al (2002) Budesonide in collagenous colitis—a double-blind placebo-controlled trial with histological follow-up. Gastroenterology 122:20–25PubMed Baert F, Schmit A, D’Haens G et al (2002) Budesonide in collagenous colitis—a double-blind placebo-controlled trial with histological follow-up. Gastroenterology 122:20–25PubMed
11.
Zurück zum Zitat Miehlke S, Heymer P, Bethke B et al (2002) Budesonide treatment for collagenous colitis—a randomized, double-blind, placebo-controlled, multicenter trial. Gastroenterology 123:978–984CrossRefPubMed Miehlke S, Heymer P, Bethke B et al (2002) Budesonide treatment for collagenous colitis—a randomized, double-blind, placebo-controlled, multicenter trial. Gastroenterology 123:978–984CrossRefPubMed
12.
Zurück zum Zitat Bonderup OK, Hansen JB, Birket-Smith L et al (2003) Budesonide treatment of collagenous colitis: a randomised, double blind, placebo controlled trial with morphometric analysis. Gut 52:248–251CrossRefPubMed Bonderup OK, Hansen JB, Birket-Smith L et al (2003) Budesonide treatment of collagenous colitis: a randomised, double blind, placebo controlled trial with morphometric analysis. Gut 52:248–251CrossRefPubMed
13.
Zurück zum Zitat Eypasch E, Wood-Dauphinee S, Williams JI et al (1993) The gastrointestinal quality of life index. A clinical index for measuring patient status in gastroenterologic surgery. Chirurg 64:264–274PubMed Eypasch E, Wood-Dauphinee S, Williams JI et al (1993) The gastrointestinal quality of life index. A clinical index for measuring patient status in gastroenterologic surgery. Chirurg 64:264–274PubMed
14.
Zurück zum Zitat Eypasch E, Williams JI, Wood-Dauphinee S et al (1995) Gastrointestinal quality of life index: development, validation and application of a new instrument. Br J Surg 82:216–222PubMed Eypasch E, Williams JI, Wood-Dauphinee S et al (1995) Gastrointestinal quality of life index: development, validation and application of a new instrument. Br J Surg 82:216–222PubMed
15.
Zurück zum Zitat Irvine EJ, Feagan B, Rochon J et al (1994) Quality of life: a valid and reliable measure of therapeutic efficacy in the treatment of inflammatory bowel disease. Canadian Crohn’s Relapse Prevention Trial Study Group. Gastroenterology 106:287–296PubMed Irvine EJ, Feagan B, Rochon J et al (1994) Quality of life: a valid and reliable measure of therapeutic efficacy in the treatment of inflammatory bowel disease. Canadian Crohn’s Relapse Prevention Trial Study Group. Gastroenterology 106:287–296PubMed
16.
Zurück zum Zitat Irvine EJ, Greenberg GR, Feagan BG et al (2000) Quality of life rapidly improves with budesonide therapy for active Crohn’s disease. Inflamm Bowel Dis 6:181–187PubMed Irvine EJ, Greenberg GR, Feagan BG et al (2000) Quality of life rapidly improves with budesonide therapy for active Crohn’s disease. Inflamm Bowel Dis 6:181–187PubMed
17.
Zurück zum Zitat Sailer M, Bussen D, Debus ES et al (1998) Quality of life in patients with benign anorectal disorders. Br J Surg 85:1716–1719CrossRefPubMed Sailer M, Bussen D, Debus ES et al (1998) Quality of life in patients with benign anorectal disorders. Br J Surg 85:1716–1719CrossRefPubMed
18.
Zurück zum Zitat Barrat C, Capelluto E, Catheline J-M et al (2001) Quality of life 2 years after laparoscopic total fundoplication: a prospective study. Surg Laparosc Endosc Percutan Tech 11:347–350PubMed Barrat C, Capelluto E, Catheline J-M et al (2001) Quality of life 2 years after laparoscopic total fundoplication: a prospective study. Surg Laparosc Endosc Percutan Tech 11:347–350PubMed
19.
Zurück zum Zitat Miehlke S, Madisch A, Bästlein E et al (2003) Time to clinical remission in patients with collagenous colitis treated with budesonide capsules—results from a randomized, double-blind, placebo-controlled trial. Gut 52:A214 Miehlke S, Madisch A, Bästlein E et al (2003) Time to clinical remission in patients with collagenous colitis treated with budesonide capsules—results from a randomized, double-blind, placebo-controlled trial. Gut 52:A214
20.
Zurück zum Zitat Fine K, Ogunji F, Lee E et al (1999) Randomized, double-blind placebo-controlled trial of bismuth subsalicylate for microscopic colitis. Gastroenterology 116:A880 Fine K, Ogunji F, Lee E et al (1999) Randomized, double-blind placebo-controlled trial of bismuth subsalicylate for microscopic colitis. Gastroenterology 116:A880
21.
Zurück zum Zitat Munck LK, Kjeldsen J, Philipsen E et al (2003) Incomplete remission with short-term prednisolone treatment in collagenous colitis: a randomized study. Scand J Gastroenterol 38:606–610CrossRefPubMed Munck LK, Kjeldsen J, Philipsen E et al (2003) Incomplete remission with short-term prednisolone treatment in collagenous colitis: a randomized study. Scand J Gastroenterol 38:606–610CrossRefPubMed
22.
Zurück zum Zitat Chande N, McDonald JW, MacDonald JK (2003) Interventions for treating collagenous colitis. Cochrane Database Syst Rev CD003575 Chande N, McDonald JW, MacDonald JK (2003) Interventions for treating collagenous colitis. Cochrane Database Syst Rev CD003575
Metadaten
Titel
Oral budesonide therapy improves quality of life in patients with collagenous colitis
verfasst von
Ahmed Madisch
Peter Heymer
Claudia Voss
Bernd Wigginghaus
Elke Bästlein
Ekkehard Bayerdörffer
Eberhard Meier
Wolfgang Schimming
Birgit Bethke
Manfred Stolte
Stephan Miehlke
Publikationsdatum
01.07.2005
Erschienen in
International Journal of Colorectal Disease / Ausgabe 4/2005
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-004-0660-y

Weitere Artikel der Ausgabe 4/2005

International Journal of Colorectal Disease 4/2005 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.