Medical therapy for Crohn's disease
1University of Chicago Hospital, Chicago, Illinois 60637, USA.
Current Opinion in Gastroenterology
|October 7, 2006
Summary
The US FDA approved infliximab for Crohn's disease treatment. While steroids offer short-term benefits, long-term management relies on immunomodulators like azathioprine and 6-mercaptopurine.
Area of Science:
- Gastroenterology
- Clinical Pharmacology
Background:
- Review of recent advancements in medical management of Crohn's disease.
- Focus on therapies approved or with new clinical data in the past year.
Purpose of the Study:
- To summarize key developments in Crohn's disease pharmacotherapy.
- To highlight the evolving roles of various drug classes in induction and maintenance therapy.
Main Methods:
- Literature review of the past year's publications on Crohn's disease medical treatment.
- Analysis of clinical trial data for aminosalicylates, antibiotics, steroids, and immunomodulators.
Main Results:
- US FDA approval of infliximab marks a significant advancement.
- Steroids (e.g., budesonide) show acute efficacy but lack long-term benefit compared to aminosalicylates.
- Azathioprine and 6-mercaptopurine remain standard for steroid-dependent Crohn's, with accumulating safety data.
- Aminosalicylates, antibiotics, and steroids show evolutionary, not revolutionary, clinical data as induction agents.
Conclusions:
- Infliximab approval is a major milestone in Crohn's disease therapy.
- Immunomodulators are crucial for long-term maintenance in steroid-dependent cases.
- Novel therapeutic approaches require further extensive clinical validation.
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