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Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport
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Bile Acid Sequestrant Therapy in Microscopic Colitis
Michael J Northcutt1, Nicole M Gentile, Jay L Goldstein
1Division of Gastroenterology, University of Chicago Medicine, NorthShore University Health System, Evanston, IL.
Journal of Clinical Gastroenterology
|January 14, 2021
Summary
Bile acid sequestrants (BAS) show promise as a corticosteroid-sparing treatment for microscopic colitis (MC). This therapy may help reduce budesonide dependence and offers a potential alternative for managing this chronic diarrheal condition.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pharmacology
Background:
- Microscopic colitis (MC) is a prevalent cause of chronic diarrhea.
- Budesonide is effective for inducing remission but high relapse rates occur after treatment cessation.
Purpose of the Study:
- To evaluate the efficacy of bile acid sequestrants (BAS) as a corticosteroid-sparing treatment for microscopic colitis (MC).
Main Methods:
- Retrospective review of 79 patients with histology-confirmed MC from an institutional registry.
- Assessment of BAS efficacy in budesonide-naive patients and as maintenance therapy in budesonide-dependent patients.
Main Results:
- 76% of budesonide-naive patients responded to BAS.
- 50% of budesonide-dependent patients reduced their budesonide dose, and 20% discontinued it completely while on BAS.
- 15% of patients stopped BAS due to intolerance or lack of perceived benefit.
Conclusions:
- Bile acid sequestrants (BAS) may serve as an effective corticosteroid-sparing agent for microscopic colitis (MC) management.
- Consideration of BAS after budesonide induction is warranted.
- Further controlled studies are necessary to confirm long-term efficacy and tolerability.
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