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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
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Updated: May 11, 2025

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Newer Immunosuppressants for Rheumatologic Disease: Preoperative Considerations.

Ye Rin Koh1, Kenneth C Cummings1

  • 1Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Avenue, E-31, Cleveland, OH 44195, USA.

Rheumatic Diseases Clinics of North America
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Summary

Managing rheumatic diseases involves various immune-modulating drugs, including small-molecule immune modulators, fusion proteins, and monoclonal antibodies. Careful consideration of risks and benefits is crucial for individualized patient care and safe perioperative management.

Keywords:
Biologic therapyMedication therapy managementPerioperative periodRheumatic diseases

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Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Rheumatic diseases encompass a range of inflammatory and autoimmune conditions.
  • Treatment options have expanded significantly with novel immunomodulatory agents.
  • These advanced therapies present unique challenges, particularly concerning surgical procedures.

Purpose of the Study:

  • To review current immunosuppressant treatments for rheumatic diseases.
  • To discuss the implications of these treatments during the perioperative period.
  • To provide evidence-based recommendations for perioperative management.

Main Methods:

  • Comprehensive literature search for immunosuppressant therapies in rheumatic diseases.
  • Analysis of perioperative risks associated with immunomodulators, fusion proteins, and monoclonal antibodies.
  • Synthesis of current guidelines and expert opinions on perioperative management.

Main Results:

  • A broad spectrum of immunosuppressants is available, each with distinct risk profiles.
  • Perioperative management requires careful balancing of immunosuppression and surgical risks.
  • Individualized patient assessment is paramount for optimizing outcomes.

Conclusions:

  • Optimal perioperative care for patients with rheumatic diseases necessitates a thorough understanding of immunosuppressant therapies.
  • Tailored management strategies are essential to mitigate risks and ensure patient safety.
  • Further research is warranted to refine perioperative protocols for these complex patient populations.