Management of Active Crohn Disease

被引:97
|
作者
Cheifetz, Adam S. [1 ,2 ]
机构
[1] Beth Israel Deaconess Med Ctr, Ctr Inflammatory Bowel Dis, Boston, MA 02215 USA
[2] Harvard Univ, Sch Med, Boston, MA USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2013年 / 309卷 / 20期
关键词
INFLAMMATORY-BOWEL-DISEASE; ULCERATIVE-COLITIS; PRACTICE GUIDELINES; RANDOMIZED-TRIAL; ACTIVITY INDEX; MAINTENANCE INFLIXIMAB; MONOCLONAL-ANTIBODY; HUMANIZED ANTIBODY; BIOLOGICAL THERAPY; AMERICAN-COLLEGE;
D O I
10.1001/jama.2013.4466
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Importance: Treatment of Crohn disease is rapidly evolving, with the induction of novel biologic therapies and newer, often more intensive treatment approaches. Knowing how to treat individual patients in this quickly changing milieu can be a challenge. Objective: To review the diagnosis and management of moderate to severe Crohn disease, with a focus on newer treatments and goals of care. Evidence Review: MEDLINE was searched from 2000 to 2011. Additional citations were procured from references of select research and review articles. Evidence was graded using the American Heart Association level-of-evidence guidelines. Results: Although mesalamines are still often used to treat Crohn disease, the evidence for their efficacy is lacking. Corticosteroids can be effectively used to induce remission in moderate to severe Crohn disease, but they do not maintain remission. The mainstays of treatment are immunomodulators and biologics, particularly anti-tumor necrosis factor. Conclusion and Relevance: Immunomodulators and biologics are now the preferred treatment options for Crohn disease. ©2013 American Medical Association. All rights reserved.
引用
收藏
页码:2150 / 2158
页数:9
相关论文
共 50 条
  • [21] Treatment of active Crohn's disease with heparin
    Dupas, JL
    Brazier, F
    Yzet, T
    Roussel, B
    Duchmann, JC
    Iglicki, F
    GASTROENTEROLOGY, 1996, 110 (04) : A900 - A900
  • [22] Treatment of active Crohn's disease with clarithromycin
    Leiper, K
    Campbell, BJ
    Rhodes, JM
    GUT, 1999, 44 (02) : 299 - 299
  • [23] Cholesterol metabolism in active Crohn's disease
    Hrabovsky, Vladimir
    Zadak, Zdenek
    Blaha, Vladimir
    Hyspler, Radomir
    Karlik, Tomas
    Martinek, Arnost
    Mendlova, Alice
    WIENER KLINISCHE WOCHENSCHRIFT, 2009, 121 (7-8) : 270 - 275
  • [24] Treatment of active Crohn's disease with clarithromycin
    Leiper, K
    Morris, AI
    Rhodes, JM
    GASTROENTEROLOGY, 1999, 116 (04) : A760 - A760
  • [25] Chronic active Crohn's disease: incidence
    Munkholm, P
    IBD AND SALICYLATES - 3, 1998, 20 (01): : 161 - 167
  • [26] Statin Therapy in Active Crohn's Disease
    Behm, Brian
    Pizarro, Theresa
    Cominelli, Fabio
    AMERICAN JOURNAL OF GASTROENTEROLOGY, 2009, 104 : S482 - S482
  • [27] Nutritional therapy for active Crohn’s disease
    Paul A Smith
    World Journal of Gastroenterology, 2008, (27) : 4420 - 4423
  • [28] Panuveitis in a patient with active Crohn's disease
    Senthamizh, Tharini
    Senthamizhselvan, Kuppusamy
    Sahoo, Niroj Kumar
    Kaliaperumal, Subashini
    BMJ CASE REPORTS, 2021, 14 (02)
  • [29] Mesalamine in the treatment of active Crohn's disease
    Dignass, A
    Marteau, P
    GASTROENTEROLOGY, 2005, 128 (01) : 245 - 246
  • [30] Natalizumab for active Crohn's disease.
    Ghosh, S
    Goldin, E
    Gordon, FH
    Malchow, HA
    Rask-Madsen, J
    Rutgeerts, P
    Vyhnalek, P
    Zádorová, Z
    Palmer, T
    Donoghue, S
    NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (01): : 24 - 32