{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:21:17Z","timestamp":1783336877306,"version":"3.54.6"},"reference-count":0,"publisher":"Universa BV","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Gastroenterol. Belg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Microscopic colitis (MC) is a chronic inflammatory bowel disorder causing watery diarrhea despite normal endoscopic findings. Budesonide is the only approved therapy, yet long-term durability and the need for alternatives in steroid-dependent or -refractory cases remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective single-center cohort study of all patients with histologically confirmed MC between 2013 and 2022, with \u22653 months of follow-up. Demographics, clinical features, treatments, and outcomes were collected. Clinical remission followed Hjortswang criteria: fewer than three stools per day or fewer than one watery stool per day on average.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 239 idiopathic MC patients met inclusion criteria. Spontaneous remission occurred in 19.2%, more often in males (OR 2.39, p=0.02). Corticosteroids, predominantly budesonide, were prescribed in 78.7% and induced remission in 75.5% within three months. Relapse affected 54.8% of responders, typically during tapering (44.6%) or shortly after cessation (55.3%). Younger age predicted relapse (OR 0.97, p=0.003). Conventional alternatives, including 5-ASA, cholestyramine, methotrexate, and azathioprine, were largely ineffective after corticosteroid failure or dependency. Advanced therapies (anti-TNF agents, vedolizumab, JAK inhibitors) were initiated in 12.6%, more often in younger patients (OR 0.95, p=0.001) and those with a family history of IBD (OR 4.11, p=0.03). These therapies achieved post-induction remission in 70% of refractory cases. Two patients required colectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large cohort with long-term follow-up, budesonide remained the primary treatment, yet over half of responders relapsed during tapering or after discontinuation. Conventional alternatives showed limited benefit. Advanced therapies demonstrated meaningful effectiveness in steroid-refractory or steroid-dependent MC, underscoring the need for broader therapeutic options.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.51821\/89.2.15176","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:01:22Z","timestamp":1783335682000},"page":"295-302","source":"Crossref","is-referenced-by-count":0,"title":["High relapse rates after budesonide in microscopic colitis: a large retrospective analysis revealing the need for advanced therapies"],"prefix":"10.51821","volume":"89","author":[{"given":"T","family":"Taelman","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Lenfant","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium"},{"name":"Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Vermeire","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium"},{"name":"Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Ferrante","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium"},{"name":"Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Sabino","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium"},{"name":"Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Verstockt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium"},{"name":"Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27062","published-online":{"date-parts":[[2026,6]]},"container-title":["Acta Gastro-Enterologica Belgica"],"original-title":[],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:01:23Z","timestamp":1783335683000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ageb.be\/ageb-journal\/ageb-volume\/ageb-article\/2292\/High%20relapse%20rates%20after%20budesonide%20in%20microscopic%20colitis:%20a%20large%20retrospective%20analysis%20revealing%20the%20need%20for%20advanced%20therapies"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6]]}},"URL":"https:\/\/doi.org\/10.51821\/89.2.15176","relation":{},"ISSN":["0001-5644","1784-3227"],"issn-type":[{"value":"0001-5644","type":"print"},{"value":"1784-3227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}