Background: Collagenous colitis is typified by chronic watery diarrhoea and characteristic histological alterations of the colonic mucosa without endoscopic abnormalities. Budesonide, a corticosteroid with high first-pass metabolism has been examined in collagenous colitis, but studies to date have had small numbers, and relatively low statistical power.
Aim: A meta-analysis of existing published trials was undertaken to evaluate the treatment effect of budesonide in collagenous colitis.
Methods: All pertinent literature sources were searched for published reports in English of budesonide use in collagenous colitis. MEDLINE and EMBASE databases were reviewed, as well as bibliographies from published articles and available abstracts from relevant meetings. Literature that met prespecified criteria was selected for the meta-analysis.
Results: Three trials were included in the meta-analysis. Budesonide significantly decreased stool frequency (budesonide vs. placebo OR: 20.1, 95% CI: 7.0-57.5, P < 0.0001). In general, budesonide treatment was well-tolerated.
Conclusions: Budesonide is clinically effective short-term in collagenous colitis, and seems to be relatively well-tolerated. Clinicians can consider this drug as a reasonable option for patients with this disorder.