Budesonide vs. RA

There are many different ways to combat arthritis. Here at CreakyJoints we have been profiling many of the standard treatments, as well as many 'up-and-coming' solutions to the myriad of problems created by arthritis. Researchers are constantly exploring new methods and reexamining older treatment as well as current drugs to see how they may affect arthritis if used in a new way. Last month in the Annals of the Rheumatic Diseases, a study was published highlighted the effectiveness of Budesonide (Entocort EC) as compared to prednisolone (Orapred, Prelone). The study found that both drugs performed comparably well.

Prednisolone is in a class of drugs called steroids. Prednisolone reduces swelling and decreases the body's immune response, making it an obvious choice to combat rheumatoid arthritis, though not without significant side effects. It is also used to treat many different conditions. It's used to treat hormonal disorders when the body does not produce enough of its own steroids. It's also used for a variety of immune related disorders in addition to combating RA. Budesonide is in a class of drugs called corticosteroids. Budesonide is currently used to reduce inflammation, in the nose (Rhinocort spray) and in the digestive system fighting Crohn's disease (Entocort EC).

Corticosteroids are medications similar to natural hormone substances produced by the body that help to reduce inflammation. They are effective in reducing disease activity and joint inflammation caused by rheumatoid arthritis. One way corticosteroids reduce inflammation is by decreasing the action of the body's immune response. While this effect can help relieve pain and swelling, it may make you more susceptible to infection. Some more traditionally used corticosteroids (in terms of arthritis treatment) include methylprednisolone (Medrol) and dexamethasone (Decadron). Budesonide has only been recently studied.

In the recent trial, Budesonide and prednisolone appear to relieve symptoms of rheumatoid arthritis shortly after initiation of treatment for at least 3 months. In addition, no rebound occurs after cessation of treatment, according to the findings of a new randomized trial. "Budesonide controlled ileal release (CIR), a locally acting glucocorticoid with minimal systemic exposure, could potentially normalise and modify the intestinal immune response and thereby indirectly induce and maintain control of the joint inflammation over and above the effect of systemically available glucocorticoids", said John R. Kirwan, MD, with the Academic Rheumatology Unit, University Division of Medicine, at the Bristol Royal Infirmary, United Kingdom, and colleagues.

While Dr. Kirwan did note that "Our results suggest there was no additional effect of budesonide over and above the systemic benefits of glucocorticoid treatment, in spite of a presumed strong local effect on the terminal ileum", continued testing may reveal more, and at the very least it appears that there is yet another weapon in the fight against RA.