Collagenous Gastritis: Characteristics and Response to Topical Budesonide.

Abstract

BACKGROUND AND AIMS:

Collagenous gastritis (CG) is a rare disorder characterized by subepithelial collagen deposition in the stomach. Standard medications have been only moderately successful in treating CG. We report results of a large, retrospective, open-label noncontrolled study of topical budesonide for CG, with an aim of establishing an alternative therapy for the disease.

METHODS:

We identified patients treated for CG at Mayo Clinic (2000-2017) with topically targeted budesonide (TTB) in 2 formulations: open-capsule budesonide or compounded immediate-release budesonide capsule. Demographic, clinical, biochemical, and histologic variables were assessed for all patients before and after treatment.

RESULTS:

We identified 64 patients with CG (50 adults, 14 children). Most were female (68%), mean age was 41 ± 22.8 years, and body mass index was 23.1 ± 5.9 kg/m2. In most pediatric patients, CG presented with abdominal pain and anemia; in adults, CG presented more often with weight loss (P < .001). Collagenous sprue or colitis were more common in patients >50 years of age (83%) vs those 19-50 years of age (27%) or <19 years of age (50%) (P < .001). Of the patients treated with TTB, 89% had a clinical response to TTB (42% complete, 46% partial), and 88% had a histologic response (53% complete, 33% partial).

CONCLUSIONS:

Adults and children with CG have a wide variety of symptoms, and notably, TTB therapy produced clinical and histologic improvement after other therapy had failed.

• Authors: Rok Seon Choung, Ayush Sharma, Victor G Chedid, Imad Absah, Zongming Eric Chen, Joseph A Murray
• Journal: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (Clin Gastroenterol Hepatol) Vol. 20 Issue 9 Pg. 1977-1985.e1 (09 2022) ISSN: 1542-7714 [Electronic] United States
• PMID: 34864160 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved.

Chemical References

• Budesonide
• Collagen

Topics

• Adolescent
• Adult
• Budesonide
• Child
• Collagen
• Female
• Gastritis
• Humans
• Malabsorption Syndromes
• Male
• Middle Aged
• Retrospective Studies
• Young Adult