Budesonide

Budesonide is a steroid medicine used to treat microscopic colitis and Crohn's disease.

6 mg once daily x 3 months

While systemic glucocorticoid therapy is associated with an appreciable risk of bone loss, the available data suggest that budesonide has limited effect on bone mineral density because of its low systemic bioavailability.[1]

In particular, budesonide therapy is associated with better preservation of bone mineral density in patients who are glucocorticoid-naïve prior to receiving budesonide. In a trial including 272 patients with Crohn disease involving the ileum and/or ascending colon, no significant differences were observed in bone mineral density at two-year follow-up between budesonide-treated patients compared with patients on prednisolone. However, the reduction in bone mineral density was significantly less in patients who had never before received glucocorticoids and were subsequently treated with budesonide compared with those receiving prednisolone. [1]

Despite this potential benefit of budesonide, patients with IBD may have other risk factors for osteoporosis including disease-related inflammatory activity, nutritional deficiency, hypogonadism, and prior use of systemic glucocorticoids.