Budesonide for Crohn's disease

Crohn's disease is characterized by recurrent transmural inflammation of the gastrointestinal tract, most commonly, the terminal ileum and the colon. Therapy is aimed at breaking the cycle of inflammation by inducing and maintaining remission. Current effective therapies include systemic corticosteroids, but this class of drugs is associated with a variety of adverse effects, which may lead to significant morbidity and even mortality. Budesonide, a potent corticosteroid designed to have location specific delivery to the gastrointestinal tract, has limited systemic bioavailability largely due to its extensive first pass metabolism and has been demonstrated to be a safer alternative to conventional corticosteroids and of proven efficacy in the induction of remission in mild to moderate Crohn's disease. However, budesonide is not effective in maintaining remission in patients with Crohn's disease.