Immunomodulators for the treatment of Crohn's disease in adults: optimal use and prospects for future drug treatments.
Fiche publication
Date publication
juillet 2016
Journal
Expert review of clinical immunology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr PEYRIN-BIROULET Laurent
Tous les auteurs :
Allen PB, Peyrin-Biroulet L
Lien Pubmed
Résumé
Crohn's disease (CD) requires treatment beyond symptoms by enabling and maintaining mucosal healing and therefore clinical remission. However, with the increasing use of biologics there have been safety concerns and there is a significant cost implication with the early use of biologics. Therefore, it is imperative that patients with severe/complicated disease or poor prognostic factors are treated with an aggressive strategy while all remaining patients should be treated in a step-up strategy. The potential for disease modification with thiopurines and methotrexate is debated in CD when they are used as a monotherapy. In this review we discuss existing and newer therapies that have recently been developed for CD. We will also provide an algorithm for current management of adult CD patients in routine clinical practice.
Mots clés
Adalimumab, Crohn’s disease, Infliximab, Methotrexate, Mongersen, Tacrolimus, Thiopurines, Tofacitinib, anti-TNF
Référence
Expert Rev Clin Immunol. 2016 Jul;12(7):741-9