A retrospective single-center cohort study published in Acta Gastro-Enterologica Belgica evaluated the long-term effectiveness of budesonide and the need for alternative therapies in 239 patients with idiopathic microscopic colitis. Spontaneous remission occurred in 19.2% of patients and was more common in males (OR: 2.39; p=0.02). Budesonide remained the primary treatment, prescribed to 78.7% of patients, and achieved clinical remission in 75.5% within three months.
However, 54.8% of responders relapsed, most commonly during dose tapering (44.6%) or shortly after treatment discontinuation (55.3%), with younger age independently associated with relapse. Conventional alternatives, including 5-aminosalicylic acid, cholestyramine, methotrexate, and azathioprine, showed limited benefit in steroid-dependent or steroid-refractory disease. In contrast, advanced therapies, including anti-TNF…
