Fluticasone Propionate in Inflammatory Bowel Disease

Although effective for both acute and often long term treatmentof inflammatory bowel disease, systemically absorbed corticosteroids have a highincidence of side effects. This article briefly reviews the pharmacokinetics ofcorticosteroids and the strategics available for reducing systemic side effects. Inparticular, fluitcasone propionate is a fluorinated glucocorticoid, in which systemicside effects are absent or minimal due to its relatively low absorption andrapid first pass metabolism In an open trial in 12 patients with mild andmoderately active Crohn's disease, administration of 20 mg fluitcasonepropionate orally was associated with a significant fall in the Crohn's diseaseactivity index and improvement in other parameters of inflammation, withoutchange in either plasma cortisol levels or responsiveness to adrenocorticotropichormone, suggesting that this drug is a promising therapy for Crohn's diseasemeriting evaluation against conventional corticosteroids