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Evidence-based treatment algorithm for mild to moderate Crohn's disease
1Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, Mayo Clinic and Mayo Medical School, Rochester, Minnesota 55905, USA.
The American Journal of Gastroenterology
|December 31, 2003
Summary
Effective Crohn's disease induction therapies include sulfasalazine, budesonide, and oral corticosteroids. Relapse management involves re-induction and immunosuppressive maintenance, with long-term budesonide as a potential alternative.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pharmacology
Background:
- Crohn's disease is a chronic inflammatory bowel disease.
- Mild to moderate disease activity requires effective treatment strategies.
Purpose of the Study:
- To outline effective induction and maintenance therapies for Crohn's disease.
- To identify alternative long-term treatment options for relapsing patients.
Main Methods:
- Review of randomized, controlled trials for Crohn's disease induction therapy.
- Analysis of treatment protocols for patients experiencing relapse.
- Evaluation of long-term budesonide use as maintenance therapy.
Main Results:
- Sulfasalazine, budesonide, and oral corticosteroids are effective for induction.
- Relapse within 6-12 months necessitates re-induction and immunosuppressive maintenance (azathioprine, 6-mercaptopurine, methotrexate).
- Long-term budesonide (6-9 mg daily) is a viable alternative for maintenance in specific patient groups.
Conclusions:
- Established induction therapies are effective for mild to moderate Crohn's disease.
- Immunosuppressive agents are standard for maintenance after induction relapse.
- Long-term budesonide offers a potential alternative to immunosuppression for select Crohn's disease patients.