[Pharmacotherapy of inflammatory bowel disease]

Inflammatory bowel disease (IBD) encompasses ulcerative colitis and Crohn's disease. Since the etiology of both diseases, is undetermined the causal therapy do not exist. Medical treatment has focused on nonspecific suppressions of the inflammatory process. There are four groups of IBD drugs: anti-inflammatory medicaments, immunomodulators, antidiarrheal agents, and biologic therapy. In a last year immunosuppressives become the very essential IBD drugs. Azathioprine is drug of choice for chronically active Crohn's disease; methotrexate become the second line immunosuppressive drug. It appears that anti-TNG monoclonal antibodies, cA2 (infliximab) may produce rapid control of active Crohn's disease and achieve tissue healing. Topically acting glucocorticosteroids are a safer than standard glicocorticosteroids in ileocolonic Crohn's disease. Cyclosporin is becoming a drug of choice in severely active ulcerative colitis. Anti-inflammatory agents, sulfasalazine and 5-ASA drugs are recommended in treatment mild and moderately active IBD and as maintenance treatment in ulcerative colitis. Corticosteroids still have the main role in the treatment of active IBD. There is no convincing data for efficacy of corticosteroids as maintenance therapy.