Department of Clinical Medicine, University of Bologna, 40138 Bologna, Italy.
World J Gastroenterol. 2011 Apr 14;17(14):1797-806. doi: 10.3748/wjg.v17.i14.1797.
Outstanding progress regarding the pathophysiology of Crohn's disease (CD) has led to the development of innovative therapeutic concepts. Numerous controlled trials have been performed in CD. This review concentrates on the results of randomized, placebo-controlled trials, and meta-analyses when available, that provide the highest degree of evidence. Current guidelines on the management of CD recommend a step-up approach to treatment involving the addition of more powerful therapies as the severity of disease and refractoriness to therapy increase. The advent of biological drugs has opened new therapeutic horizons for treating CD, modifying the treatment goals. However, the large majority of patients with CD will be managed through conventional therapy, even if they are a prelude to biological therapy.
在克罗恩病(CD)的病理生理学方面取得了显著进展,从而推动了创新治疗理念的发展。目前已经在 CD 中开展了大量的对照试验。本综述重点关注随机、安慰剂对照试验的结果,以及在有条件的情况下进行的荟萃分析,这些结果提供了最高级别的证据。目前 CD 的管理指南建议采用逐步治疗方法,随着疾病的严重程度和对治疗的反应性增加,逐渐增加更有效的治疗方法。生物药物的出现为治疗 CD 开辟了新的治疗前景,改变了治疗目标。然而,即使是生物治疗的前奏,大多数 CD 患者仍将通过传统治疗进行管理。