Ulcerative colitis: predictors of budesonide multimatrix treatment failure

Takeaway

• More than half of the patients with mild to moderate ulcerative colitis (UC) respond to treatment with oral, extended-release budesonide multimatrix (MMX); patients less likely to respond include men and those aged ≤29 years at diagnosis.

Why this matters

• Budesonide MMX offers potential safety benefits over commonly used systemic corticosteroid therapies for UC, but it may have limited efficacy among some populations.

Study design

• Researchers studied the health records of patients with UC treated with budesonide MMX (N=96; median age, 38.0 [interquartile range, 28-53.5] years; 72% women), using univariate and multivariable analyses to identify factors associated with inadequate response.
• Funding: Crohn’s and Colitis Foundation; NIH.

Key results

• Most of the patients (54%) responded to budesonide MMX, but 46% were nonresponders requiring transition to prednisone.
• Predictors of MMX nonresponse included male sex (39% vs 19% [P=.035]; aOR, 2.96 [95% CI, 1.12-7.77]) and age ≤29 years at UC diagnosis (median age, 23.5 vs 29 years [P=.034]; aOR, 3.10 [95% CI, 1.21-7.95]).

Limitations

• Retrospective, single-centre design with a small sample size.