1st Department of Medicine, Semmelweis University, Koranyi, Budapest, Hungary.
World J Gastroenterol. 2011 Oct 21;17(39):4372-81. doi: 10.3748/wjg.v17.i39.4372.
In the last decades, with the development of biological therapy, the treatment paradigms in patients with Crohn's disease have continuously evolved. Several studies focusing on the optimal use of both traditional immunosuppressants and biological therapy have been published, investigating conventional, accelerated step-up and top-down approaches. In addition, much emphasis has been placed in recent years on the determination of important predictive factors that could enable early patient stratification, which would lead to a tailored management strategy. In this review, the authors try to highlight new evidence on the optimal timing, benefits, and risks of immunosuppressants alone, or in combination, in patients with Crohn's disease.
在过去几十年中,随着生物治疗的发展,克罗恩病患者的治疗模式不断演变。已经发表了几项关于传统免疫抑制剂和生物治疗最佳使用的研究,研究了传统、加速升级和自上而下的方法。此外,近年来人们非常重视确定重要的预测因素,这些因素可以实现早期患者分层,从而制定个体化的管理策略。在这篇综述中,作者试图强调关于克罗恩病患者单独使用或联合使用免疫抑制剂的最佳时机、益处和风险的新证据。