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Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

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Related Experiment Videos

Glucocorticosteroids for primary sclerosing cholangitis.

Vanja Giljaca1, Goran Poropat, Davor Stimac

  • 1Department of Gastroenterology, Clinical Hospital Centre Rijeka, Kresimirova 42, Rijeka, Rijeka, Croatia, 51000.

The Cochrane Database of Systematic Reviews
|January 22, 2010
PubMed
Summary

Glucocorticosteroids show no proven benefit for primary sclerosing cholangitis (PSC). Intrabiliary corticosteroid use may cause severe adverse events, with no clear advantage over other treatments for this chronic liver disease.

Related Experiment Videos

Area of Science:

  • Hepatology
  • Gastroenterology
  • Clinical Pharmacology

Background:

  • Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease leading to bile duct inflammation, fibrosis, cirrhosis, and increased risk of cholangiocarcinoma.
  • PSC is strongly associated with inflammatory bowel disease (IBD), affecting over 80% of patients.
  • Current treatments, including ursodeoxycholic acid and immunomodulators, have not reversed PSC progression, with liver transplantation being the only definitive solution for advanced disease.

Purpose of the Study:

  • To evaluate the efficacy and safety of glucocorticosteroids in managing primary sclerosing cholangitis.
  • To assess the beneficial and harmful effects of glucocorticosteroids for patients diagnosed with PSC.

Main Methods:

  • A systematic review of randomized clinical trials was conducted, searching major databases (Cochrane Hepato-Biliary Group, Cochrane Library, MEDLINE, EMBASE, LILACS) up to September 2009.
  • Eligible trials compared glucocorticosteroids (any dose/duration) against placebo, no intervention, or other immunosuppressants, irrespective of language, blinding, or publication status.
  • Data extraction and quality assessment were performed independently, with meta-analyses presenting results as relative risks (RR) or mean differences (MD) with 95% confidence intervals (CI). Primary outcomes included mortality and liver-related morbidity.

Main Results:

  • Two eligible randomized clinical trials involving a total of 35 patients were included.
  • One trial comparing hydrocortisone via biliary lavage showed a trend towards increased adverse events (pancreatitis, sepsis, paranoia) and no cholangiographic improvement, leading to early termination.
  • A second trial comparing budesonide versus prednisone found significantly higher serum bilirubin levels with prednisone treatment, with no other significant clinical or biochemical outcome differences.

Conclusions:

  • There is currently insufficient evidence to support or refute the use of oral glucocorticosteroids for primary sclerosing cholangitis.
  • Intrabiliary administration of corticosteroids through a nasobiliary tube appears to be associated with severe adverse effects.
  • Further research is needed to establish the role, if any, of glucocorticosteroids in PSC management.