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[炎症性肠病治疗的当前概念,生物疗法]

[Current concepts about the treatment of inflammatory bowel disease, biological therapy].

作者信息

Bosques-Padilla F J, Galindo-Marines S L, Yamamoto-Farusho J K

机构信息

Servicio de Gastroenterología. Departamento de Medicina Interna. Hospital Universitario "Dr. José Eleuterio González". Facultad de Medicina.Universidad Autónoma de Nuevo León.

出版信息

Rev Gastroenterol Mex. 2008;73(4):217-30.

Abstract

BACKGROUND

Crohn's disease and ulcerative colitis are chronic inflammatory disease of the intestine,which frequently require surgery for complications or failure of medical therapy.

OBJECTIVE

We seek evidence and provide direction for clinicians about the optimal use of biologic therapy in order to enable steroid free remission in inflammatory bowel disease.

METHODS

Scientific literature was reviewed using MEDLINE with a specific focus on biologic medical therapies for inducing and maintaining remission of Crohn disease and ulcerative colitis.

RESULTS

Several therapies have demonstrated efficacy for the treatment of active, moderate-to-severe Crohn disease and ulcerative colitis. These include agents which induce remission [infliximab, certolizumaband adalimumab (CD only)] or maintain remission and spare corticosteroids [infliximab,certolizumab and adalimumab (CD only)]. In the patient with UC there is evidence about the efficacy of Infliximab for induce remission in moderate to-severe cases. We present additional information about new drugs in development for the treatment of both diseases.

CONCLUSION

There are evidence about the efficacy and safety of biologic therapies that maximize remission and minimize corticosteroid dependence in patients with moderate-to-severe CD and UC.

摘要

背景

克罗恩病和溃疡性结肠炎是肠道慢性炎症性疾病,常因并发症或药物治疗失败而需要手术治疗。

目的

我们寻找证据并为临床医生提供关于生物治疗最佳应用的指导,以使炎症性肠病患者实现无激素缓解。

方法

使用医学主题词表(MEDLINE)对科学文献进行综述,特别关注用于诱导和维持克罗恩病及溃疡性结肠炎缓解的生物医学疗法。

结果

几种疗法已证明对治疗活动期、中重度克罗恩病和溃疡性结肠炎有效。这些疗法包括诱导缓解的药物[英夫利昔单抗、赛妥珠单抗和阿达木单抗(仅用于克罗恩病)]或维持缓解且节省皮质类固醇的药物[英夫利昔单抗、赛妥珠单抗和阿达木单抗(仅用于克罗恩病)]。对于溃疡性结肠炎患者,有证据表明英夫利昔单抗在中重度病例中诱导缓解有效。我们还提供了有关正在研发的用于治疗这两种疾病的新药的更多信息。

结论

有证据表明生物治疗在中重度克罗恩病和溃疡性结肠炎患者中有效且安全,可最大程度实现缓解并最小化对皮质类固醇的依赖。

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