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Current Gastroenterology Reports

, Volume 2, Issue 6, pp 446–450 | Cite as

Medical therapies for ulcerative colitis and crohn’s disease

  • Filip J. Baert
  • Paul J. Rutgeerts
Article

Abstract

This review focuses on data reported in the last year on medical treatment of Crohn’s disease and ulcerative colitis. In Crohn's disease, a broad range of cytokine-based therapies are currently being tested. Although all are very exciting, the anti-tumor-necrosis-factor (TNF) approach remains the most effective, with infliximab (a chimeric monoclonal antibody directed against TNF) being the most active agent. With repeated infusions every 8 weeks, remission is induced and can be maintained even in refractory patients with no major apparent side effects. Thalidomide, an oral agent with anti-TNF effects, shows promise in noncontrolled experience. Important new data on azathioprine/ 6-mercaptopurine (6-MP) and its metabolites are also helpful. Methotrexate can induce remissions in 6-MP-allergic or refractory Crohn's patients and has now shown efficacy as a maintenance agent. Beneficial effects are also reported for a variety of new agents: mycophenolate mofetil, tacrolimus (FK506), growth hormone, and granulocyte colony-stimulating factor (G-CSF). Important observations in ulcerative colitis (UC) over the past year include evidence of a protective effect of 5-aminosalicylic acid (5-ASA) with respect to colorectal cancer, negative results from a study for heparin monotherapy, and results from a comparison of mycophenolate mofetil versus azathioprine as maintenance therapy. Epidemiologically, the negative association between appendectomy and UC was corroborated in a meta-analysis, suggesting an immunologic role for this organ. Finally, in chronic pouchitis, probiotic therapy was found to maintain remissions very significantly.

Keywords

Ulcerative Colitis Infliximab Thalidomide FK506 Mycophenolate Mofetil 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Current Science Inc 2000

Authors and Affiliations

  • Filip J. Baert
    • 1
  • Paul J. Rutgeerts
    • 1
  1. 1.Departments of Gastroenterology and Internal MedicineUniversity Hospital GasthuisbergLeuvenBelgium

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