Review ArticlesBudesonide treatment for microscopic colitis: systematic review and meta-analysisSebastian, Shajia,b; Wilhelm, Annikac; Jessica, Lislea; Myers, Sallya; Veysey, MartinbAuthor Information aIBD Unit, Hull and East Yorkshire NHS Trust bHull York Medical School, Hull cTillotts Pharma UK Ltd, Lincoln, UK Correspondence to Shaji Sebastian, MD, FRCP, IBD Unit, Department of Gastroenterology, Hull and East Yorkshire NHS Trust, Hull HU17 0SH, UK Tel: +44 148 267 4321; fax: +44 148 267 5200; e-mail: email@example.com European Journal of Gastroenterology & Hepatology: August 2019 - Volume 31 - Issue 8 - p 919-927 doi: 10.1097/MEG.0000000000001456 Buy SDC Metrics Abstract Microscopic colitis (MC), encompassing lymphocytic and collagenous colitis, is a common cause for chronic nonbloody diarrhoea, which impacts significantly on the quality of life for patients. Despite increasing awareness of the condition and its treatment, there is considerable variation in therapeutic approaches. To conduct a systematic review and meta-analysis on the efficacy and safety of budesonide in the treatment of MC. We searched Medline, Embase and Central databases using predefined search methodology for randomised trials using budesonide in the treatment of MC. We extracted data, on the efficacy and safety of budesonide, from studies identified that met the feasibility for analysis criteria. These data were pooled with a fixed effects model. Nine studies met the inclusion criteria for analysis. The pooled odds ratios (ORs) for a response to budesonide therapy at induction and maintenance were 7.34 [95% confidence interval (CI): 4.08–13.19] and 8.35 (95% CI: 4.14–16.85) respectively. Histological response rates were superior in budesonide-treated patients compared to placebo following induction (OR: 11.52; 95% CI: 5.67–23.40) and maintenance treatment (OR: 5.88; 95% CI: 1.90–18.17). There was no difference in adverse events. Significant relapse rates (>50%) were observed following treatment cessation with no difference noted between the budesonide or the placebo-treated patients. Budesonide is an effective treatment option for MC for achieving induction and maintenance of both clinical and histological response. High relapse rates on treatment cessation were observed. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.