P347. Collagenous colitis: The clinical response after therapy with budesonide plus mesalazine and maintenance with mesalazine
A. Scarcelli1, A. Bertani1, M. Di Girolamo1, A. Merighi1, V. Boarino1, A. Antonioli1, A.M. Primerano1, E. Villa1
1Policlinico Modena, Italy
Background: Collagenous colitis (CC) is a microscopic colitis characterized by watery diarrhoea, normal colonic mucosa at colonoscopy, presence at the histology of a thickened sub-epithelial collagen band. Many Various case reports proposed different treatments. The aim of this study was to evaluate the clinical response (numbers of daily stools, subject wellness) after starting therapy with budesonide plus mesalazine and after maintenance therapy with mesalazine. We evaluated the daily stools and the subject wellness after 6 months, 1 and 2 years of the ending of the budesonide therapy.
Methods: Since January 2005 to September 2011 arrived in our Unit 20 CC. They referred on average 5–6 watery stools evacuations/day. In blood tests VES (erythrocyte sedimentation velocity) and PCR (protein C reactive) were normal. 7 patients didn't make the budesonide therapy because of other severe pathologies; 1 patient was yet in therapy with metilprednisolone 4 mg for rheumatic disease; 13 patients (7 men and 6 women) started with budesonide 9 mg/day for the first month, 6 mg/day for second months and 3 mg/day for the third month in association with 2400 mg/day of mesalazine that patients maintained also after the budesonide cycle.
Results: After 6 months since the ending of budesonide all the patients referred a sensible reduction of the evacuation with normalisation of stool consistence (1–2 evacuation/day) and general wellness. After 1 year 8 patients referred 1–2 normal stools evacuation/day and were in general wellness too. One woman and 1 man had a relapse of watery diarrhoea, so we repeated the budesonide cycle with immediately improvement of the conditions. Finally after 2 years of follow-up 9 patients are currently in wellness. VES and PCR were always normal.
Conclusions: A therapy with budesonide plus mesalazine and a maintenance with only mesalazine can improve clinical conditions (stools' consistence and number of evacuations) in patients with CC.