Pred Alternatives

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Date Joined Jun 2008
Total Posts : 24
   Posted 8/28/2009 2:37 PM (GMT -6)   
I'm currently tapering and am at 7mg per day. I'm going down slowly about 1-2 mg per week. I hope to get off soon.

I have to say the Pred really helped and there was a while that I felt great. Of course, now I'm dealing with the side effects - osteoporosis and elevated sugar levels. I'm hoping these get better as I get off the Pred.

I came across these drugs and was wondering if anyone has any experience with them. They appear to have the benefits of Pred with less side effects. I have emailed my GI but have not heard from him. Anyone have any insight or experience they can share?

Controlled-release Beclomethasone Dipropionate (Clipper)

Beclomethasone dipropionate (BDP) is a second-generation steroid with topical effects and minimal systemic activity.[49] An oral controlled release preparation of BDP (Clipper; Chiesi Pharmaceuticals, Parma, Italy) has an acid-resistant film coating (Eudragit-L100/55) that dissolves at pH < 6, releasing the active drug in the distal small bowel and colon.[50] Campieri et al. demonstrated that BDP has equivalent efficacy to 5-ASA in the treatment of extensive and left sided active UC.[51]

A double-blind placebo-controlled trial evaluated the efficacy of BDP added to 5-ASA in the treatment of extensive or left sided active UC. One hundred and nineteen patients were randomized to receive BDP (5 mg daily) or placebo; all patients received oral 5-ASA (3.2 g daily). More patients in the BDP plus 5-ASA group achieved clinical remission than the placebo and 5-ASA group after 4 weeks of treatment (58.6% vs. 34.4%, P = 0.008).[52]

Biancone et al. showed in a controlled trial that BDP liquid enema, BDP foam enema, mesalazine liquid enema and mesalazine foam have comparable tolerability and efficacy in mildly active distal UC.[53]

Oral Prednisolone Metasulfobenzoate (Predocol)

In a double-blind randomized study, Rhodes et al. compared the efficacy and safety of a sparingly absorbed formulation of prednisolone metasulfobenzoate (predocol) with a conventional tapering course of oral prednisolone in 181 patients with active UC. Fifty-nine patients were randomized to Predocol 40 mg/day for 6 months, 61 patients to Predocol 60 mg/day for 6 months, and 61 patients to oral prednisolone 40 mg/day for 2 weeks, tapered to zero after 8 weeks, followed by placebo until 6 months. Remission rates at 2 months were 46%, 28% and 41% respectively (P = 0.13). Remission rates at 6 months also did not differ significantly between the treatment arms. Predocol 40 mg/day had markedly fewer side effects than a conventional tapering prednisolone regimen.[54]

MMX Budesonide

D'Haens et al. studied the safety and efficacy of budesonide MMX 9 mg in patients with active left-sided UC. Thirty-six patients were treated with budesonide MMX 9 mg extended release tablets (Cosmo Technologies Ltd, Dublin, Ireland) for 8 weeks or placebo (blinded phase) for 4 weeks followed by budesonide MMX 9 mg for 4 weeks. Eight of 17 patients (47%) in the budesonide group and five of 15 patients (33%) in the placebo group responded, defined as a reduction in colitis activity index (CAI) of at least 50% or a CAI ≤ 4. There was no significant suppression of the adrenocortical function in patients who had budesonide compared with those who had placebo.[55]
Dx w/ UP in 2005; Dx with UC in 2008
Was taking: Lialda and Mesalmine Enema (1x per day); Colazal (9 per day);
Now Taking: Pred-a 10 mg/day down from 40mg but experiencing bone loss; Apriso - 4 per day; mesalmine enema nightly
Tricor for Cholesterol
Male; age 43; Located in Atlanta

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