Bertin Luisa, Crepaldi Martina, Zanconato Miriana, Lorenzon Greta, Maniero Daria, De Barba Caterina, Bonazzi Erica, Facchin Sonia, Scarpa Marco, Ruffolo Cesare, Angriman Imerio, Buda Andrea, Zingone Fabiana, Savarino Edoardo Vincenzo, Barberio Brigida
Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
Chirurgia Generale 3 Unit, Azienda Ospedale Università di Padova, Padua, Italy.
Clin Exp Gastroenterol. 2024 Oct 10;17:261-315. doi: 10.2147/CEG.S434014. eCollection 2024.
Crohn's disease (CD) is a complex, chronic inflammatory bowel disease characterized by unpredictable flare-ups and periods of remission. Despite advances in treatment, CD remains a significant health burden, leading to substantial direct healthcare costs and out-of-pocket expenses for patients, especially in the first-year post-diagnosis. The impact of CD on patients' quality of life is profound, with significant reductions in physical, emotional, and social well-being. Despite advancements in therapeutic options, including biologics, immunomodulators, and small molecules, many patients struggle to achieve or maintain remission, leading to a considerable therapeutic ceiling. This has led to an increased focus on novel and emerging treatments. This context underscores the importance of exploring advanced and innovative treatment options for managing refractory CD. By examining the latest approaches, including immunomodulators, combination therapies, stem cell therapies, and emerging treatments like fecal microbiota transplantation and dietary interventions, there is an opportunity to gain a comprehensive understanding of how best to address and manage refractory cases of CD.
克罗恩病（CD）是一种复杂的慢性炎症性肠病，其特征为不可预测的发作和缓解期。尽管治疗取得了进展，但CD仍然是一项重大的健康负担，给患者带来了大量的直接医疗费用和自付费用，尤其是在确诊后的第一年。CD对患者生活质量的影响是深远的，会导致身体、情感和社会幸福感显著下降。尽管治疗选择有所进步，包括生物制剂、免疫调节剂和小分子药物，但许多患者仍难以实现或维持缓解，导致了相当大的治疗瓶颈。这使得人们越来越关注新型和新兴治疗方法。这种背景凸显了探索先进和创新治疗方案以管理难治性CD的重要性。通过研究最新方法，包括免疫调节剂、联合疗法、干细胞疗法以及粪便微生物群移植和饮食干预等新兴治疗方法，有机会全面了解如何最好地应对和管理难治性CD病例。
