Are we giving biologics too late? The case for early late use

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摘要 CorticosteroidsandimmunomodulatorshavebeenthemainstaytherapiesforCrohn’sdisease.Corticosteroidsarehighlyeffectivetocontrolsymptomsintheshort-term,buttheyarenoteffectiveinmaintainingremission,theyhealthemucosainareducedproportionofcases,andlong-timeexposureisassociatedwithanincreasedriskofinfectionsandmortality.Immunomodulators,azathioprineandmethotrexate,healthemucosainahigherproportionofpatientsthatcorticosteroidsbuttheironsetofactionisslowandtheybenefitlessthanhalfofpatientswithCrohn’sdisease.Inthelastdecade,medicaltherapyforCrohn’sdiseasehasexperiencedaremarkablechangeduetotheintroductionofbiologictherapy,andparticularlytheuseofanti-tumournecrosisfactor-alphaagents.Infliximab,adalimumab,andcertolizumabpegolhavedemonstratedefficacyforinductionandmaintenanceofremissioninactiveCrohn’sdisease.TheseagentshaveraisedthebarforwhatisasuitablesymptomaticresponseinCrohn’sdiseaseandmodificationofthenaturalhistoryofthediseasehasbecomeamajorgoalinthetreatmentofCrohn’sdisease.Thereareseveraldataintheliteraturethatsuggestthatearlyuseofbiologictherapyandachievementofmucosalhealingcontributetodiseasecoursemodification.However,manyquestionsonearlybiologicaltherapyforCrohn’sdiseaseremainstillunanswered.
机构地区 不详
出版日期 2008年12月22日(中国期刊网平台首次上网日期,不代表论文的发表时间)
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