Management of active Crohn disease.
Management of active Crohn disease.
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DOI：
10.1001/jama.2013.4466
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发表时间：
2013-05-22
期刊：
影响因子：
--
通讯作者：
Cheifetz AS
中科院分区：
文献类型：
--
作者：
Cheifetz AS
随着新型生物疗法和更新、通常更强化的治疗方法的出现，克罗恩病的治疗正在迅速发展。了解如何在这个快速变化的环境中治疗个体患者可能是一个挑战。回顾中度至重度克罗恩病的诊断和治疗，重点关注新的治疗方法和护理目标。 MEDLINE 的检索时间为 2000 年至 2011 年。其他引文来自精选研究和评论文章的参考文献。使用美国心脏协会证据水平指南对证据进行分级。尽管美沙拉嗪仍常用于治疗克罗恩病，但缺乏其疗效的证据。皮质类固醇可有效用于诱导中度至重度克罗恩病的缓解，但不能维持缓解。治疗的支柱是免疫调节剂和生物制剂，特别是抗肿瘤坏死因子。免疫调节剂和生物制剂现在是克罗恩病的首选治疗选择。
Treatment of Crohn disease is rapidly evolving, with the induction of novel biologic therapies and newer, often more intensive treatment approaches. Knowing how to treat individual patients in this quickly changing milieu can be a challenge. To review the diagnosis and management of moderate to severe Crohn disease, with a focus on newer treatments and goals of care. MEDLINE was searched from 2000 to 2011. Additional citations were procured from references of select research and review articles. Evidence was graded using the American Heart Association level-of-evidence guidelines. Although mesalamines are still often used to treat Crohn disease, the evidence for their efficacy is lacking. Corticosteroids can be effectively used to induce remission in moderate to severe Crohn disease, but they do not maintain remission. The mainstays of treatment are immunomodulators and biologics, particularly anti–tumor necrosis factor. Immunomodulators and biologics are now the preferred treatment options for Crohn disease.
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