| Theme |
Now is the time for the "Intestine" -- updates and problems raised to be solved in IBD |
| Title |
The position of biologics for Crolin's disease |
| Author |
Koji Yoshida |
The Division of Lower Gastroenterology, Hyogo College of Medicne |
| Author |
Takayuki Matsumoto |
The Division of Lower Gastroenterology, Hyogo College of Medicne |
| [ Summary ] |
Since a precise mechanism controlling Crohn's disease has not been clarified, most patients have been treated with nutritional therapy and 5-aminosalicylates in Japan. However, after introducing molecular targeted therapies such as infliximab in late 1990's, treatment strategies for Crohn's disease have changed dramatically.
Infliximab is used not only to induce remission in patients with active Crohn's disease who are refractory to other drugs but also to maintain long term clinical remission. Recent data has shown that the drug is also capable of inducing mucosal healing in substantial subsets of the disease. Although mucosal healing may be an ideal goal to be achieved by first line therapies, early intervention with infliximab for Crohn's disease may be beneficial since those patients are likely to maintain states of remission for long periods. Therefore, this therapy may change the natural history of Crohn's disease. However, infliximab has potential side effects such as infusion reactions and induction of infections including tuberculosis. It is essential to monitor such adverse reactions and use premedication to reduce the risks if necessary. |