Diagnosis and management of microscopic colitis

Table 1 Annual incidence/100 000 inhabitants in population-based epidemiological studies of CC and LC[5,6,11-17]

Region and study period	CC	LC
Örebro, Sweden 1984-1988	0.8
Örebro, Sweden 1989-1993	2.7
Örebro, Sweden 1993-1995	3.7	3.1
Örebro, Sweden 1996-1998	6.1	5.7
Örebro, Sweden 1999-2004	5.2	5.5
Terassa, Spain 1993-1997	2.3	3.7
Iceland 1995-1999	5.2	4.0
Olmsted County, USA 1985-1989	0.3	0.5
Olmsted County, USA 1990-1993	1.6	1.0
Olmsted County, USA 1994-1997	3.9	6.4
Olmsted County, USA 1997-2001	6.2	12.9
Lothian, UK 1998-2003	0.8
Tayside, UK 1999-2004	1.1	0.6
Calgary, Canada 2002-2004	4.6	5.4

Table 2 Data from four randomized, placebo-controlled trials of oral budesonide in CC and LC

Author year	Number of cases	Dosage	Clinical response budesonide vs placebo	Histological response budesonide vs placebo	Adverse events
Collagenous colitis
Baert et al[91] 2002	28	9 mg/d Budenofalk 8 wk	Improvement: 8/14 vs 3/14 (P = 0.05)	Reduction of lamina propria inflammation in 9/13 vs 4/12 (P < 0.001) No difference in collagen layer	Mild No difference between treatment groups
Miehlke et al[93] 2002	45	9 mg/d Entocort 6 wk	Remission: 15/23 vs 0/22 (P < 0.0001)	Improvement in 17/23 vs 5/22 (P < 0.01) No difference in collagen layer	Mild 38% vs 12% P = 0.052
Bonderup et al[92] 2003	20	9 mg/d Entocort 8 wk	Response: 10/10 vs 2/10 (P < 0.001)	Reduction of overall inflammation (P < 0.01) and of collagen layer in sigmoid colon (P < 0.02)	None
Lymphocytic colitis
Miehlke et al[95] 2007	41	9 mg/d Budenofalk 6 wk	Remission: 18/21 vs 8/20 (P = 0.004)	Response in 11/15 vs 4/12 (P = 0.04)	Mild No difference between treatment groups