Therapy

Why?

• Rectal steroids improve symptoms and increase remission rates. ^a
• Rectal steroids are more effective than oral prednisolone ^a though not clearly better than rectal budesonide. ^a
• The combination of oral and rectal steroids is not clearly better than rectal steroids alone. ^d

Ulcerative colitis: rectal steroids improve symptoms and increase remission

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
distal ulcerative colitis a	rectal corticosteroids	placebo	symptomatic improvement at 2-3 weeks	34%	0.21 (0.07 to 0.71)	4 (3 to 14)
			symptomatic remission at 2-3 weeks	9%	0.07 (0.02 to 0.29)	12 (11 to 16)

Ulcerative colitis: rectal steroids lead to more remissions than oral steroids

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
distal ulcerative colitis a	rectal corticosteroid	oral steroids	clinical remission at 2 weeks	35%	-110% (-230% to -30%)	3 (2 to 6)