Programs for Assessment of Technology in Health Research Institute, St Joseph's Healthcare, Hamilton, 25 Main Street West, Suite 2000 ON, Canada.
Expert Rev Pharmacoecon Outcomes Res. 2010 Apr;10(2):163-75. doi: 10.1586/erp.10.13.
Crohn's disease (CD) is a chronic inflammatory bowel disease with a relatively high prevalence rate in North America. More than 50% of CD patients require surgery at some stage of their disease. Anti-TNF-alpha drugs are increasingly being used in patients with CD who have had an inadequate response to conventional therapy. Treatment with anti-TNF-alpha agents aims at improving symptom control and reducing the need for hospitalization and surgery. This review examines the clinical effectiveness of three anti-TNF-alpha agents (infliximab, adalimumab and etanercept) in moderate and severe CD. The review further considers the evidence for the harms and benefits associated with switching from one anti-TNF-alpha agent to another and strategies to optimize the timing of therapy.
克罗恩病（CD）是一种慢性炎症性肠病，在北美地区的患病率相对较高。超过 50%的 CD 患者在疾病的某个阶段需要手术。抗 TNF-α 药物在对传统治疗反应不足的 CD 患者中越来越多地被使用。抗 TNF-α 药物的治疗旨在改善症状控制，减少住院和手术的需求。本综述检查了三种抗 TNF-α 药物（英夫利昔单抗、阿达木单抗和依那西普）在中重度 CD 中的临床疗效。本综述进一步考虑了从一种抗 TNF-α 药物转换为另一种药物相关的危害和益处的证据，以及优化治疗时机的策略。
