| Theme |
Up-to-date Treatment for Inflammatory Bowel Diseases |
| Title |
Efficacy of Immunosuppressive Agents for Crohn's Disease |
| Author |
Tetsuro Takayama |
Department of Internal Medicine, Keio University School of Medicine |
| Author |
Makoto Naganuma |
Department of Internal Medicine, Keio University School of Medicine |
| Author |
Toshifumi Hibi |
Department of Internal Medicine, Keio University School of Medicine |
| [ Summary ] |
Immunosuppressive agents are becoming increasingly important drugs for the treatment of Crohn's disease. 6-Mercaptopurine (6-MP) and the prodrug azathioprine (AZA) are primarily used and are effective for maintenance therapy, steroid reduction and fistula closure. Since the activity of metabolizing enzymes of 6-MP / AZA is low in the Japanese population, clinical efficacy for Crohn's patients can be obtained in lower doses compared to Caucasian patients. Bone marrow suppression, liver dysfunction, gastroenterological disorders, acute pancreatitis and other conditions are reported as side effects of immunosuppressive agents. Moreover, it is known that several months are required to achieve the immunosuppressive effects. Current evidence suggests that 6-MP / AZA are essential drugs in the treatment of Crohn's disease, however, thorough examination of the indications for treatment and informed consent are indispensable prior to its administration. |