Abstract:
:Corticosteroids are considered a drug of choice for the treatment of patients with moderately to severely active Crohn's disease (CD), an inflammatory bowel disease characterized by chronic recurrent flares of disease activity. However, among patients receiving corticosteroid therapy for induction of remission, 20% have corticosteroid-refractory disease and 36% of those with an initial response develop corticosteroid dependency within 1 year. Chronic corticosteroid exposure in patients who are corticosteroid dependent increases the risk for serious drug-related adverse effects. Withdrawal or reduction of corticosteroid therapy without exacerbation of symptoms is therefore recognized as an important goal of treatment. Therapies that have been shown to facilitate "steroid sparing' include the immunomodulators azathioprine/6-mercaptopurine and methotrexate and the antitumor necrosis factor-alpha monoclonal antibody infliximab. In corticosteroid-dependent patients, budesonide may be substituted for conventional corticosteroid therapy without loss of response and with less risk for toxicity, but its long-term efficacy requires further evaluation. A preliminary controlled study suggests that the investigational anti-TNF monoclonal antibody CDP-571 may also be clinically beneficial as a corticosteroid-sparing agent. This review summarizes the clinical evidence that supports consideration of these agents as alternatives in patients with CD who are dependent on, refractory to, or intolerant of conventional corticosteroid therapy.
journal_name
Inflamm Bowel Disjournal_title
Inflammatory bowel diseasesauthors
Lichtenstein GRdoi
10.1002/ibd.3780070506keywords:
subject
Has Abstractpub_date
2001-05-01 00:00:00pages
S23-9eissn
1078-0998issn
1536-4844journal_volume
7 Suppl 1pub_type
杂志文章,评审abstract::The diagnosis of inflammatory bowel disease (IBD) is traditionally based on a combination of clinical, endoscopic, histological, and radiological criteria. However, further testing is needed in cases of diagnostic uncertainty and in predicting disease course. This systematic review focuses on the potential for 10 sero...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,评审
doi:10.1002/ibd.21903
更新日期:2012-07-01 00:00:00
abstract::: Patients with ulcerative colitis are at increased risk for colorectal adenocarcinoma compared with the general population. Although surveillance for colorectal malignancy and dysplasia (a premalignant lesion) has been recommended, a benefit in reducing mortality from colorectal cancer via surveillance or prophylacti...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Genetic susceptibility may play a more important role in the etiology of early-onset inflammatory bowel disease (IBD) than in late-onset IBD, and therefore pediatric-onset IBD patients can be expected to have a higher frequency of gene mutations. We aimed to determine genotypes and phenotypes of patients wit...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.20171
更新日期:2007-09-01 00:00:00
abstract:Background:Clinical trials investigating the use of cannabinoid drugs for the treatment of intestinal inflammation are anticipated secondary to preclinical literature demonstrating efficacy in reducing inflammation. Methods:We systematically reviewed publications on the benefit of drugs targeting the endo-cannabinoid ...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,meta分析
doi:10.1093/ibd/izy014
更新日期:2018-03-19 00:00:00
abstract:BACKGROUND:In our clinical practice, women often report excess weight gain with infliximab (IFX) use. There are currently no studies investigating weight gain after antitumor necrosis factor therapy in patients with inflammatory bowel disease. The objective of this study was to evaluate the association of clinical fact...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1093/ibd/izz133
更新日期:2020-01-01 00:00:00
abstract::: Primary nonresponse and primary nonremission are important limitations of tumor necrosis factor (TNF) antagonists, occurring in 10% to 40% and 50% to 80% of patients with inflammatory bowel disease, respectively. The magnitude of primary nonresponse differs between phase III clinical trials and cohort studies, indic...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0000000000000202
更新日期:2015-01-01 00:00:00
abstract::Most conventional forms of drug therapy suppress or modify the host immunoinflammatory response and neglect the other contributor to disease pathogenesis-the environmental microflora. Probiotics are live microbial food ingredients that alter the enteric microflora and have a beneficial effect on health. The rationale ...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,评审
doi:10.1097/00054725-200005000-00007
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Aside from cases of backwash ileitis, the ileal mucosa of patients with ulcerative colitis (UC), an idiotypic inflammatory bowel disease, has received little attention despite the fact that colitis is known to trigger alterations in morphology and/or functions of the small intestine remotely. METHODS:The il...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0000000000000871
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Inflammatory bowel disease (IBD) affects people during their prime reproductive years. The thiopurines (6-mercaptopurine and azathioprine), commonly used for induction and maintenance of remission, are U.S. Food and Drug Administration (FDA) pregnancy category D, raising concern for fetal risk. We performed ...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,评审
doi:10.1002/ibd.22948
更新日期:2013-01-01 00:00:00
abstract::Skin manifestations are common in patients suffering from inflammatory bowel disease (IBD) and can be associated with the disease itself, with nutritional deficiencies, or with therapy. All drugs currently used for treating IBD have the potential to cause dermatologic manifestations that can have a wide range of clini...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,评审
doi:10.1097/MIB.0b013e3182802c07
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Children with inflammatory bowel disease (IBD) undergo imaging using ionizing radiation and may be exposed to high cumulative radiation. We hypothesized that children with IBD have high exposure to radiation from medical imaging. METHODS:An Institutional Review Board (IRB)-approved retrospective chart revie...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.21626
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Mesalamine suppositories are first-line therapy in active ulcerative proctitis; the standard regime still recommends multiple doses per day. The primary objective of this study was to show the noninferiority of once-daily administration of a novel 1 g mesalamine suppository versus thrice-daily administration...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/ibd.21258
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:To systematically determine the performance of diffusion-weighted imaging magnetic resonance enterography (DWI-MRE) for evaluating bowel inflammation in Crohn's disease and sources of heterogeneity between reported results. METHODS:We identified research studies that investigated DWI-MRE to diagnose bowel i...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MIB.0000000000000607
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Inflammatory bowel diseases (IBDs) are chronic illnesses that require frequent and regular healthcare contact. Regular maintenance care may reduce complications or the need for hospitalization. Availability of physicians may be an important determinant of IBD hospitalizations. METHODS:Using 2008 inpatient d...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.21357
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Patients suffering from Crohn's disease (CD) show increased incidence of low bone mineral density. Investigating this complication is difficult because the exact etiology of CD remains elusive. Mice carrying a deletion in the tumor necrosis factor (TNF) AU-rich elements (ARE) are reported as a model for huma...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.20385
更新日期:2008-06-01 00:00:00
abstract::Gastrointestinal disorders, although clinically heterogeneous, share pathogenic mechanisms, including genetic susceptibility, impaired gut barrier function, altered microbiota, and environmental triggers (infections, social and behavioral factors, epigenetic control, and diet). Gut microbiota has been studied for infl...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,评审
doi:10.1097/MIB.0000000000000602
更新日期:2016-02-01 00:00:00
abstract::: Inflammatory bowel disease is associated with a reduction in serum and red blood cell folate levels that may contribute to colonic carcinogenesis. Sulfasalazine may exacerbate such deficiencies. Indirect evidence suggests that folate supplements reduce the risk of colonic neoplasia in those using this agent, althoug...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Inflammatory bowel disease is a chronic inflammatory disorder of the gastrointestinal tract that significantly impacts the health-related quality of life (HR-QOL). A decreased HR-QOL has been demonstrated in patients with active disease compared with patients in remission. In this cross-sectional study, we e...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0b013e318281f395
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Increased strength of red blood cell (RBC) aggregates are present during the acute inflammatory response and contribute to erythrocyte aggregation and may lead to microvascular dysfunction. Inflammatory bowel diseases (IBDs) are characterized by damage to the bowel wall. This damage may be at least partially...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.20838
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:The risk of corticosteroid-associated adverse events can limit the use of systemic corticosteroids. Oral, topically acting, second-generation corticosteroids that deliver drug to the site of inflammation, and biologic therapies, are effective treatment alternatives. The aim of this review was to evaluate the...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,评审
doi:10.1097/MIB.0000000000001261
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Interestingly, Clostridium difficile infection (CDI) worsens the course of inflammatory bowel disease (IBD); however, there is a paucity of data regarding the treatment of CDI in this group of patients. METHODS:This was a prospective, single-blind trial. Children with flare of IBD and CDI were randomly assi...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,随机对照试验
doi:10.1097/MIB.0000000000001249
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Improving granulocyte function may represent an effective therapy for Crohn's disease (CD). We performed a Phase I-2 trial of sargramostim (SRG) in children with CD. METHODS:This was multicenter, open-label study in 6-16-year-old patients with moderate to severely active CD. Patients received either 4 or 6 ...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,多中心研究
doi:10.1002/ibd.21204
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Mucosal dye spraying (chromoendoscopy [CE]) has been shown in controlled studies to enhance lesion detection in colitis surveillance. Narrow band imaging (NBI) potentially offers a more convenient mode of highlighting mucosal lesions. The primary objectives of this study were to compare CE and NBI in colitis...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0b013e31829637b9
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Evidence supports the role of adherent invasive Escherichia coli (AIEC) in the pathogenesis of inflammatory bowel disease (IBD). However, little is known about the phylogenetic structure and origin of this group of bacteria. Multi-locus sequence typing (MLST), and fimH sequence analysis were performed to elu...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.20966
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Many treatment options exist for children with inflammatory bowel disease (IBD), yet the lack of clinical guidelines for management has lead to great variation in care. The purpose of this project was to evaluate current treatment modalities in children from the Northeast US who applied to the 2010 session o...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1002/ibd.22837
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The purpose was to estimate the incidence and characteristics of childhood inflammatory bowel disease (IBD) during 2000-2010 in Shanghai, China. METHODS:IBD patients between the ages of 0 and 18 years old were identified by survey of computerized medical information. Relevant data were extracted from their ...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章,多中心研究
doi:10.1097/MIB.0b013e318286f9f2
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:We describe the prolonged clinical benefit of murine chimeric antitumor necrosis factor (TNF)-alpha monoclonal antibody, infliximab, on pediatric patients with Crohn's disease and ileal pouch anal anastomosis (IPAA). METHODS:A retrospective review of patients originally diagnosed with ulcerative colitis, sta...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/00054725-200407000-00013
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Clinical observations or animal studies implicate enteric glial cells in motility disorders, irritable bowel syndrome, inflammatory bowel disease, gastrointestinal (GI) infections, postoperative ileus, and slow transit constipation. Mechanisms underlying glial responses to inflammation in human GI tract are ...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0000000000000854
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Increased lymphatic vessel (LV) density has been found in uninflamed intestinal wall of patients with Crohn's disease (CD). The goal of the study was to search for an association between LV density in the proximal ileal resection margin at the time of surgery and endoscopic recurrence. METHODS:Ileocolonic r...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0b013e3182971cec
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Endoscopic balloon dilation (EBD) is an effective method for treating stricture-related obstruction in Crohn's disease. We aimed to identify factors predictive of successful avoidance of surgery, including endoscopic features, in patients undergoing balloon dilation. METHODS:We performed a retrospective rev...
journal_title:Inflammatory bowel diseases
pub_type: 杂志文章
doi:10.1097/MIB.0000000000001181
更新日期:2017-10-01 00:00:00