The Most Significant Advances in the Management of Crohn’s Disease
The Most Significant Advances in the Management of Crohn’s Disease
European Gastroenterology & Hepatology Review Volume4 Issue 2
Published: October 2009
Published: October 2009
Patients with Crohn’s disease (CD) have a very disabling course and often lack a realistic hope of a cure. For a number of decades, corticosteroids, aminosalycilates and immunosuppressive drugs have represented the mainstay of medical treatment of CD for the induction and maintenance of remission. Over the last few decades, advancing knowledge of the pathogenetic mechanisms underlying chronic inflammation in the gut, together with increasing progress in bio-technology, have led to the development of a number of biological agents selectively targeting specific molecules and/or pathways involved in gut inflammation. Progress has also been made in the use of the conventional immunosuppressors alone and in combination with biological agents. This article provides insights into the most significant advances in the management of CD that have appeared in the literature in the last few years.
Biological Agents
Infliximab (a chimaeric humanised anti-tumour necrosis factor [TNF]-α antibody) was the first TNF-α inhibitor approved for the treatment of both CD and ulcerative colitis. In refractory CD, infliximab induces and maintains remission, guarantees healing of gut mucosa, dramatically induces closure and healing of fistulae and improves extraintestinal manifestations and quality of life.1,2 Infliximab may induce immunogenicity and development of autoantibodies (ATIs), which may in turn be the cause of the adverse effects and loss of efficacy over time.3 Safety data have shown an increased risk of opportunistic infections among infliximab users, including tuberculosis.4 Therefore, all patients who undergo treatment with an anti TNF-α agent should be screened for latent tuberculosis and other infections (hepatitis B virus [HBV], hepatitis C virus [HCV], HIV).
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Keywords:
Crohn’s Disease, corticosteroids, Inflammatory Bowel Disease, Crohn’s Therapy,
Crohn’s Disease, corticosteroids, Inflammatory Bowel Disease, Crohn’s Therapy,
