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Titolo:
Altering the natural history of Crohn's disease?
Autore:
Sninsky, CA;
Indirizzi:
Digest Dis Associates, Gainesville, FL 32611 USA Digest Dis Associates Gainesville FL USA 32611 Gainesville, FL 32611 USA
Titolo Testata:
INFLAMMATORY BOWEL DISEASES
, volume: 7, anno: 2001, supplemento:, 1
pagine: S34 - S39
SICI:
1078-0998(200105)7:<S34:ATNHOC>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
NECROSIS-FACTOR-ALPHA; ANTIBODY INFLIXIMAB; CONTROLLED TRIAL; AZATHIOPRINE; BUDESONIDE; PREVENTION; RECURRENCE; MANAGEMENT; TERM;
Keywords:
Crohn's disease; inflammatory bowel disease; intestinal mucosa; endoscopic healing; infliximab; corticosteroids; immunosuppressants;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Sninsky, CA Digest Dis Associates, 6400 W Newberry Rd,Suite 302, Gainesville, FL 32611USA Digest Dis Associates 6400 W Newberry Rd,Suite 302 Gainesville FL USA 32611
Citazione:
C.A. Sninsky, "Altering the natural history of Crohn's disease?", INFLAMM B D, 7, 2001, pp. S34-S39

Abstract

With the medical advances achieved in Crohn's disease (CD) over the past several years, treatment goals have expanded to include not only improvementin clinical outcomes, but also potential alteration of underlying disease processes and modification of the clinical course. A reliable prospective predictive model for the clinical course of CD is presently lacking. However, preliminary evidence suggests that the clinical expression of CD may reflect at least in part transmural and superficial mucosal inflammatory changes. Treatments that induce healing of the intestinal mucosa and submucosa may therefore provide particular clinical benefits, including sustained response or remission. As a result. endoscopic outcomes in patients with CD are increasingly included as therapeutic efficacy end points in clinical studies. Corticosteroids have been shown to rapidly relieve symptoms in most patients but generally do not improve endoscopic lesions in parallel with clinical response and are ineffective as maintenance therapy. Open-label investigations suggest that azathioprine is associated with mucosal healing; in addition, placebo-controlled studies have demonstrated that this immunosuppressive agent can provide long-term suppression of disease activity, althoughinitial onset of clinical action is slow. The antitumor necrosis factor-alpha monoclonal antibody infliximab provides endoscopic healing in parallel with clinical improvement and also effectively maintains remission with retreatment. As the relationship between endoscopic and clinical changes in disease activity is further explored and clarified, new treatment strategies will need to be developed to improve long-term prognosis in patients with CD.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 08/07/20 alle ore 07:53:02