Current Gastroenterology Reports

, 16:384

Positioning Therapy for Crohn’s Disease

Authors

  • Alexandra Gutierrez
    • Section of Gastroenterology and Hepatology, Department of MedicineWashington University in St. Louis
    • Gastroenterology DivisionWashington University School of Medicine
    • Section of Gastroenterology and Hepatology, Department of MedicineWashington University in St. Louis
    • Gastroenterology DivisionWashington University School of Medicine
Inflammatory Bowel Disease (S Hanauer, Section Editor)

DOI: 10.1007/s11894-014-0384-2

Cite this article as:
Gutierrez, A. & Dassopoulos, T. Curr Gastroenterol Rep (2014) 16: 384. doi:10.1007/s11894-014-0384-2
Part of the following topical collections:
  1. Topical Collection on Inflammatory Bowel Disease

Abstract

The therapy of Crohn’s disease is constantly evolving. It is widely recognized that clinical assessment does not stage disease activity accurately and that endoscopic healing is associated with improved long-term outcomes. Disease management is therefore transitioning to a new paradigm that includes direct assessment of disease severity (endoscopically in most patients), followed by assessment of mucosal healing. New approaches have helped optimize the use of the thiopurines, methotrexate and anti-TNF agents. Novel agents with different mechanisms of action are expanding our therapeutic armamentarium. The major challenge of the future will be to identify patient subgroups best suited to particular therapeutic approaches. In the meantime, studies of comparative effectiveness will be crucial in positioning therapies relative to each other.

Keywords

Crohn’s disease Immunomodulators Anti-TNF Antibodies

Abbreviations

6-MMPR

6-methyl-mercaptopurine ribonucleotides

6-TGN

6-thioguanine nucleotides

ADA

Adalimumab

AZA

Azathioprine

AZTEC

Azathioprine for Treatment of Early Crohn’s disease in adults

CD

Crohn’s disease

CDAI

Crohn’s disease activity index

CI

Confidence interval

COMMIT

Combination of Maintenance Methotrexate-Infliximab Trial

CZP

Certolizumab pegol

EBV

Epstein-Barr Virus

HR

Hazard ratio

IFX

Infliximab

IL

Interleukin

IMM

Immunomodulators

MP

Mercaptopurine

MTX

Methotrexate

OR

Odds ratio

RAPID

Résultat de l’Adjonction Précoce d’ImmunoDépresseurs

RBC

Red blood cells

RR

Relative Risk

SIR

Standardized incidence ratio

TNFα

Tumor necrosis factorα

TPMT

Thiopurine methyltransferase

Copyright information

© Springer Science+Business Media New York 2014