Crohn Disease (Crohn's Disease)

A chronic transmural inflammation that may involve any part of the DIGESTIVE TRACT from MOUTH to ANUS, mostly found in the ILEUM, the CECUM, and the COLON. In Crohn disease, the inflammation, extending through the intestinal wall from the MUCOSA to the serosa, is characteristically asymmetric and segmental. Epithelioid GRANULOMAS may be seen in some patients.

Also Known As:

Networked: 12139 relevant articles (1624 outcomes, 1678 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Ulcerative Colitis
2.	Rheumatoid Arthritis
3.	Fistula
4.	Necrosis
5.	Inflammatory Bowel Diseases (Inflammatory Bowel Disease)

Experts

1.	Rutgeerts, Paul: 135 articles (01/2016 - 01/2002)
2.	Sandborn, William J: 119 articles (01/2016 - 01/2002)
3.	Van Assche, Gert: 64 articles (12/2015 - 08/2002)
4.	Hanauer, Stephen B: 63 articles (11/2014 - 05/2002)
5.	Feagan, Brian G: 59 articles (12/2015 - 01/2002)
6.	Colombel, Jean-Frédéric: 57 articles (01/2016 - 01/2002)
7.	Rutgeerts, P: 54 articles (04/2015 - 01/2000)
8.	Rogler, Gerhard: 53 articles (12/2015 - 05/2002)
9.	Vermeire, Séverine: 52 articles (12/2015 - 05/2004)
10.	Schreiber, Stefan: 52 articles (01/2015 - 05/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Crohn Disease:

1.	infliximab (Remicade)FDA Link 01/31/2010 - "In our study infliximab induction therapy was effective in most pediatric patients with therapy refractory Crohn disease." 01/01/2014 - "Colonoscopy performed after the third infliximab showed remarkable improvement in the ileocolitis. " 11/01/2013 - "The infliximab (IFX) has dramatically improved the treatment of Crohn's disease (CD). " 10/04/2009 - "Treatment with the chimeric monoclonal antibody (infliximab) is highly effective in refractory and fistulising Crohn's disease, nevertheless, infliximab resistance may occur. " 03/01/2008 - "Infliximab (IFX) therapy is highly efficacious for the induction and maintenance of remission in pediatric Crohn disease (CD). "
2.	Tumor Necrosis Factor-alpha (Tumor Necrosis Factor)IBA 08/01/2013 - "Both thiopurines and anti-tumor necrosis factor (TNF) α agents are effective for treating Crohn's disease (CD) as they can induce clinical remission (CR) and mucosal healing (MH) in most patients. " 03/01/1999 - "Both are anti-TNF alpha monoclonal antibody formulations with proven efficacy at doses of 5 mg/kg for inducing remission in patients with moderate to severe refractory Crohn's disease. " 01/01/2002 - "The relatively recent development of genetically engineered agents has the potential to alter the treatment of Crohn's disease radically, and drugs that inhibit tumor necrosis factor-alpha (TNFalpha) have been introduced as a new therapeutic class with high efficacy, rapid onset of action, prolonged effect, and improved tolerance. " 04/01/2001 - "TNF alpha is a pro-inflammatory cytokine in Crohn's disease and it's neutralization is beneficial in patients with active disease. " 01/01/2013 - "Results in Crohn's disease were more mitigated, albeit with a symptomatic improvement in patients refractory to tumor necrosis factor-α inhibitors. "
3.	adalimumab (Humira)FDA Link 10/01/2015 - "Efficacy of thiopurines and adalimumab in preventing Crohn's disease recurrence in high-risk patients - a POCER study analysis." 10/01/2015 - "In Crohn's disease patients at high risk of post-operative recurrence adalimumab is superior to thiopurines in preventing early disease recurrence." 09/01/2013 - "Compared to placebo adalimumab can induce significantly more often steroid-free remission and mucosal healing in patients with moderate to severe Crohn's disease, reduce the rate of Crohn's disease-related hospitalisations and surgery and improve health-related quality of life. " 02/01/2013 - "Adalimumab therapy significantly improved work productivity and disease-specific quality of life for patients with moderate to severe Crohn's disease. " 05/01/2007 - "Esophageal Crohn's disease treated successfully with adalimumab."
4.	Azathioprine (Imuran)FDA LinkGeneric 04/01/2007 - "Most patients with Crohn's disease in longstanding remission had low self-reported adherence to azathioprine. " 01/01/2009 - "Azathioprine withdrawal in patients with Crohn's disease maintained on prolonged remission: a high risk of relapse." 10/01/2013 - "In a study of adults with Crohn's disease, early azathioprine therapy was no more effective than placebo to achieve sustained corticosteroid-free remission but was more effective in preventing moderate to severe relapse in a post hoc analysis. " 01/17/2000 - "Azathioprine/6MP (AZA/6MP) is effective in long-term treatment (> 3 months) of Crohn's disease and superior to other established medical treatments. " 04/01/1997 - "Medical treatment (corticosteriod therapy, with or without azathioprine) was usually effective initially for treatment of symptomatic colonic Crohn's disease, but sustained remission was rare. "
5.	Adrenal Cortex Hormones (Corticosteroids)IBA 08/01/2007 - "When used correctly, corticosteroids are a highly effective, well tolerated, cheap and generally safe treatment for active Crohn' disease. " 10/01/2001 - "Corticosteroids are highly effective in inducing clinical remission in patients with active Crohn's disease. " 02/02/1995 - "Although corticosteroids are highly effective in improving symptoms of Crohn's disease, they may have substantial toxicity. " 09/29/1994 - "Corticosteroids are the most efficacious drugs for inducing remission in active Crohn's disease, but their benefits are frequently offset by serious side effects. " 08/01/1997 - "Twenty-two patients (12 males, median age 30 years, range 18-60) with moderately active Crohn's disease were enrolled in a randomized study in which the efficacy of an elemental diet administered orally was compared to high-dose corticosteroids in achieving clinical and laboratory remission. "
6.	Mesalamine (Mesalazine)FDA LinkGeneric 10/01/1997 - "Recent data indicate that 5-aminosalicylic acid (5-ASA) is most effective in preventing relapse of Crohn's disease in patients with a short duration of remission before enrollment. " 03/01/1996 - "The aim of this study was to test the efficacy of a 12-week oral intake of Claversal in the prevention of endoscopic recurrences after 'curative' resection for ileal, colonic or ileocolonic Crohn's disease. " 04/01/1995 - "Included were 59 patients who had proven Crohn's disease of at least 1 year's duration, and who had been in continuous remission for at least 6 months, while taking only 5-aminosalicylic acid or no therapy at all. " 05/23/1998 - "The efficacy of mesalazine in active Crohn's disease is limited and high doses are required (4000 mg/day). " 05/01/1995 - "Although the major part of continuous-release mesalamine is delivered to the colon, large proportions are liberated and available at high concentrations within the small intestinal lumen, thus explaining its therapeutic efficacy in small intestinal Crohn's disease."
7.	Methotrexate (Mexate)FDA LinkGeneric 06/01/1996 - "Methotrexate appears effective in most patients with refractory Crohn's disease and its short-term toxicity is acceptable, but the long-term benefit seems more limited." 05/01/2009 - "Methotrexate is beneficial in maintaining remission and steroid-sparing treatment in children with Crohn disease following failure of thiopurine therapy." 01/01/2009 - "A pooled analysis (n = 98) including one high quality trail (n = 76) showed that intramuscular methotrexate (15 mg/week) was significantly more effective than placebo for maintenance of remission in Crohn's disease (OR 3.11; 95% CI 1.31 to 7.41; P = 0.01). " 01/01/2014 - "Large-scale studies of methotrexate given orally at higher doses for maintenance of remission in Crohn's disease may provide stronger evidence for the use of methotrexate in this manner." 01/01/2014 - "Moderate quality evidence indicates that intramuscular methotrexate at a dose of 15 mg/week is superior to placebo for maintenance of remission in Crohn's disease. "
8.	6-Mercaptopurine (Mercaptopurine)FDA LinkGeneric 01/01/1999 - "AZA and its metabolite 6-mercaptopurine (6-MP) are effective in the treatment of active Crohn's disease. " 10/01/2000 - "6-Mercaptopurine in maintaining remission in Crohn's disease: An old friend becomes a new hero." 10/01/2013 - "A small placebo-controlled trial reported the efficacy of mercaptopurine therapy for children newly diagnosed with Crohn's disease, yet little is known about the efficacy of early thiopurine therapy in adults. " 08/01/2012 - "To evaluate the efficacy of elemental diet versus 6-mercaptopurine as maintenance therapy in Crohn's disease. " 07/01/1997 - "To date, none of the five patients who were placed on 6-mercaptopurine have had recurrence of their Crohn's disease (mean disease-free period 32.6 +/- 18.4 months). "
9.	Budesonide (Pulmicort)FDA LinkGeneric 08/01/2002 - "Budesonide is significantly more effective than placebo or 5-ASA for inducing remission of active Crohn's disease. " 11/01/1995 - "Oral treatment with controlled release budesonide 9 mg/day for 8 weeks produces clinical remission in 42 to 67% of patients with active Crohn's disease of the ileum, ileocaecal region and/or ascending colon and significantly reduces Crohn's disease activity index scores compared with baseline and placebo. " 01/01/2009 - "Therefore, budesonide is not recommended for maintenance of remission in Crohn's disease." 04/01/1997 - "The evidence presented here is that budesonide (Entocort, Astra Pharma) 9 mg/day is superior to placebo and equivalent to systemically active glucocorticosteroids in achieving disease remission in patients with active Crohn's disease, and in prolonging the recurrence time of symptomatic disease. " 02/01/1996 - "In an enteric-coated formulation budesonide is more effective than placebo in achieving and maintaining remission in patients with ileocecal Crohn's disease. "
10.	SteroidsIBA 08/01/1994 - "Steroids are highly effective in active Crohn's disease; clinical relapse following steroid withdrawal, however, is frequent. " 01/01/1992 - "Steroids are very useful drugs in the treatment of active Crohn's disease (CD), but clinical relapses after steroid withdrawal may be very high. " 08/01/1997 - "These data suggest that, in the short term, an oral elemental diet is at least as effective as steroids in inducing remission of mild-moderately active Crohn's disease, but it may be more effective in improving the nutritional status of these patients, probably through a more rapid restoration of normal intestinal permeability." 02/01/1990 - "The present study strongly suggests that elemental diet is superior to steroids for treating active Crohn's disease." 03/01/1996 - "Our meta-analysis indicated that steroids are more effective than defined-formula diets for inducing remission in active Crohn's disease. "

Therapies and Procedures

1.	Enteral Nutrition (Feeding, Tube) 03/01/2013 - "Although the evidence level is not striking, enteral nutrition may be useful for maintaining remission in patients with quiescent Crohn's disease. " 09/01/1997 - "Enteral nutrition may now be recommended as the first-line treatment for most children with Crohn's disease. " 10/01/2015 - "The treatment armamentarium in pediatric Crohn disease (CD) is very similar to adult-onset CD with the notable exception of the use of exclusive enteral nutrition (EEN [the administration of a liquid formula diet while excluding normal diet]), which is used more frequently by pediatric gastroenterologists to induce remission. " 06/14/2015 - "Exclusive enteral nutrition involves the use of a complete liquid diet, with the exclusion of normal dietary components for a defined period of time, as a therapeutic measure to induce remission in active Crohn's disease (CD). " 01/01/2014 - "A limited body of research suggests that ongoing maintenance enteral nutrition (MEN) can be beneficial in maintaining disease remission in Crohn's Disease (CD). "
2.	Remission Induction 01/01/2001 - "There is no significant difference in the efficacy of elemental and non-elemental diets for induction of remission of Crohn's disease." 02/15/2007 - "In Crohn's disease, GLP-2 is superior to placebo in the induction of remission. " 10/25/2015 - "Although MTX has also been shown to be an effective agent for remission induction and maintenance of remission in Crohn's disease, the use of MTX in Crohn's disease has not yet been reported in Korea. " 03/01/2010 - "None of the probiotics thus far tested has been shown to be effective in induction of remission or in maintenance of remission in patients with Crohn's disease. " 06/01/1993 - "These results indicated that ED therapy was effective not only for the induction of remission but also for the maintenance of remission in Crohn's disease."
3.	Biological Therapy 10/25/2015 - "Although new biologic therapy has dramatically improved the treatment of Crohn's disease, a substantial number of patients are refractory to these therapies or lose their initial response. " 01/01/2004 - "The most recent breakthrough has been in the field of biological therapy for maintenance of remission in Crohn's disease. " 01/01/2010 - "The observed increase in placebo remission rates over time in trials of parenteral biologic therapies in Crohn's disease is explained by longer times to the primary endpoint in more recent trials." 08/01/2014 - "Letter: biologic therapies are effective for prevention of post-operative Crohn's disease recurrence - authors' reply." 08/01/2014 - "Letter: biological therapies are effective for prevention of post-operative Crohn's disease recurrence."
4.	Drug Therapy (Chemotherapy) 06/01/2015 - "Intestinal resection of all macroscopic Crohn's disease in patients treated with postoperative prophylactic drug therapy is associated with significant and sustained improvement in HRQoL irrespective of type of drug treatment or endoscopic recurrence. " 04/01/1992 - "We have conducted a meta-analysis of 12 placebo controlled trials to determine the efficacy of single drug therapy in Crohn's disease for both induction (seven trials) and maintenance (five trials) of remission. " 01/01/2013 - " Target disease: Crohn's disease Users: Clinical practitioners in internal medicine, surgery, gastroenterology, and general practice Purpose: To provide appropriate clinical indicators to practitioners Scope of clinical indicators: Concept of Crohn's disease, epidemiology, classifications, diagnosis, treatment, follow up, and special situations Intervention: Diagnosis (interview, physical examination, clinical laboratory tests, imaging, and pathology) and treatment (lifestyle guidance, drug therapy, nutritional therapy, surgery, etc.) Outcome assessment: Attenuation of symptoms, induction and maintenance of remission, imaging findings, quality of life (QOL), prevention of complications and harm of therapy Methods for developing these guidelines: Described in the text Basis of recommendations: Integration of evidence level and consensus of experts Cost-benefit analysis: Not implemented Evaluation of effectiveness: Yet to be confirmed Status of guidelines: Updated version of the first Guidelines published in 2010 Publication sources: Printed publication available and electronic information in preparation Patient information: Not available Date of publication: October 2011 These guidelines were intended primarily to be used by practitioners in Japan, and the goal of these guidelines is to improve the outcomes of patients with Crohn's disease." 12/01/2001 - "Various drugs (and/or surgery in Crohn's disease) are used to induce remission, and maintenance drug therapy is commonly given to prevent relapse once remission is achieved. " 12/12/1987 - "Remission of Crohn's disease with antimycobacterial chemotherapy."
5.	Total Parenteral Nutrition 11/01/1998 - "These results suggest that nutritional therapy by total parenteral nutrition and elemental diet is superior to polymeric diet for treating active phase of Crohn's disease with marked inflammatory reactions." 05/01/1985 - "Thus total parenteral nutrition with complete bowel rest appears to be an effective therapeutic modality in the primary management of complicated Crohn's disease." 10/01/1977 - "The acute phase of Crohn's disease in a 14 year old female was effectively treated with total parenteral nutrition (TPN) and an elemental diet (ED). " 10/01/2006 - "The clinical course of 145 patients with Crohn's disease, who were primarily induced into remission by total parenteral nutrition, was reviewed. " 12/01/1998 - "In Crohn's disease, elemental diets and total parenteral nutrition often induce remission, possibly by reducing antigenic load on activated immune cells in the intestine and, thus, down-regulating hyperreactive CD4 cells. "