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[Medical therapy of inflammatory bowel diseases: Crohn's disease].

Abstract
The therapy of inflammatory bowel diseases is based on 5-aminosalicylates (5-ASAs) that are the forefront of treatment of mild-to-moderate active disease and maintenance; steroids are used for the treatment of moderate-to-severe active disease; immunosuppressives and sometimes antibiotics in moderate-to-severe disease; maintenance and for the treatment of selected complications. The last few years have witnessed a significant change in the treatment of Crohn's disease. Based on evidence from new clinical studies and recent meta-analyses, the role of and indications for conventional therapy have been reassessed. The 5-ASAs are nowadays less frequently used in both active disease and maintenance therapy. Instead, budesonide has been introduced in the treatment of mild-to-moderate ileal disease. Besides the modest use of 5-ASAs, steroids are prescribed for active colonic disease. Immunosuppressives, especially azathioprine, are more commonly used in moderate-to-severe disease as well as in maintenance. The preferred maintenance regimen following medically- and surgically-induced remission, in addition to relationship between medical and surgical therapies, has also changed. The recent introduction of new "biological" therapy represents a major, promising change in the therapy of resistant and penetrating disease.
AuthorsLászló Lakatos, Péter László Lakatos
JournalOrvosi hetilap (Orv Hetil) Vol. 148 Issue 24 Pg. 1107-14 (Jun 17 2007) ISSN: 0030-6002 [Print] Hungary
Vernacular TitleA gyulladásos bélbetegségek gyógyszeres kezelése: Crohn-betegség.
PMID17561480 (Publication Type: English Abstract, Journal Article, Review)
Chemical References
  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal
  • Gastrointestinal Agents
  • Immunosuppressive Agents
  • Mesalamine
  • Budesonide
  • Infliximab
  • Azathioprine
  • Methotrexate
Topics
  • Acute Disease
  • Adrenal Cortex Hormones (therapeutic use)
  • Anti-Inflammatory Agents (therapeutic use)
  • Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
  • Antibodies, Monoclonal (therapeutic use)
  • Azathioprine (therapeutic use)
  • Budesonide (therapeutic use)
  • Chronic Disease
  • Crohn Disease (complications, drug therapy, surgery)
  • Fistula (etiology, prevention & control)
  • Gastrointestinal Agents (therapeutic use)
  • Humans
  • Immunosuppressive Agents (therapeutic use)
  • Inflammatory Bowel Diseases (drug therapy)
  • Infliximab
  • Mesalamine (therapeutic use)
  • Methotrexate (therapeutic use)
  • Severity of Illness Index

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