Tadashi Yokoyama1, Akihiko Ohta2, Satoshi Motoya3, Masakazu Takazoe4, Toshitaka Yajima5, Masataka Date5, Masahiro Nii5, Péter Nagy6, Yasuo Suzuki7, Toshifumi Hibi8. 1. Yokoyama Hospital for Gastroenterological Diseases, Nagoya, Japan. 2. IEDA Hospital, Aichi, Japan. 3. Sapporo-Kosei General Hospital, Sapporo, Japan. 4. Tokyo Yamate Medical Center, Tokyo, Japan. 5. AstraZeneca K.K., Osaka, Japan. 6. AstraZeneca R&D Gothenburg, Mölndal, Sweden. 7. Toho University Sakura Medical Center, Sakura, Japan. 8. Kitasato Institute Hospital, Kitasato University, Tokyo, Japan.
Abstract
BACKGROUND: US and European guidelines recommend budesonide for the treatment of mild-to-moderate active ileocolic Crohn's disease (CD). However, budesonide has not been approved, and mesalazine is widely used as first-line treatment in Japan. The objective of this study was to evaluate the efficacy and safety of budesonide in patients with mild-to-moderate active CD in Japan. METHODS: In this phase 3 noninferiority study (NCT01514240), 112 patients with a baseline Crohn's Disease Activity Index (CDAI) score of 180-400 were randomized to budesonide or mesalazine for 8 weeks. Assessments included remission rate (CDAI score ≤150) at weeks 2, 4, and 8, change in CDAI score, health-related quality of life (measured using the Inflammatory Bowel Disease Questionnaire [IBDQ]), and tolerability. RESULTS: The remission rate at week 8 was numerically higher in the budesonide group (30.4%) than in the mesalazine group (25.0%), and the noninferiority of budesonide to mesalazine was shown. The mean total CDAI score decreased to a greater extent with budesonide than with mesalazine. Mean IBDQ scores improved from baseline to weeks 2, 4, 8, and 10 in both groups; improvements were numerically higher with budesonide than with mesalazine. No safety concerns were found. CONCLUSION: Budesonide is comparably effective to mesalazine in the treatment of Japanese patients with mild-to-moderate active CD.
BACKGROUND: US and European guidelines recommend budesonide for the treatment of mild-to-moderate active ileocolic Crohn's disease (CD). However, budesonide has not been approved, and mesalazine is widely used as first-line treatment in Japan. The objective of this study was to evaluate the efficacy and safety of budesonide in patients with mild-to-moderate active CD in Japan. METHODS: In this phase 3 noninferiority study (NCT01514240), 112 patients with a baseline Crohn's Disease Activity Index (CDAI) score of 180-400 were randomized to budesonide or mesalazine for 8 weeks. Assessments included remission rate (CDAI score ≤150) at weeks 2, 4, and 8, change in CDAI score, health-related quality of life (measured using the Inflammatory Bowel Disease Questionnaire [IBDQ]), and tolerability. RESULTS: The remission rate at week 8 was numerically higher in the budesonide group (30.4%) than in the mesalazine group (25.0%), and the noninferiority of budesonide to mesalazine was shown. The mean total CDAI score decreased to a greater extent with budesonide than with mesalazine. Mean IBDQ scores improved from baseline to weeks 2, 4, 8, and 10 in both groups; improvements were numerically higher with budesonide than with mesalazine. No safety concerns were found. CONCLUSION: Budesonide is comparably effective to mesalazine in the treatment of Japanese patients with mild-to-moderate active CD.
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