TY - JOUR
T1 - Positioning therapy for Crohn's disease
AU - Gutierrez, Alexandra
AU - Dassopoulos, Themistocles
PY - 2014/6
Y1 - 2014/6
N2 - The therapy of Crohn's disease is constantly evolving. It is widely recognized that clinical assessment does not stage disease activity accurately and that endoscopic healing is associated with improved long-term outcomes. Disease management is therefore transitioning to a new paradigm that includes direct assessment of disease severity (endoscopically in most patients), followed by assessment of mucosal healing. New approaches have helped optimize the use of the thiopurines, methotrexate and anti-TNF agents. Novel agents with different mechanisms of action are expanding our therapeutic armamentarium. The major challenge of the future will be to identify patient subgroups best suited to particular therapeutic approaches. In the meantime, studies of comparative effectiveness will be crucial in positioning therapies relative to each other.
AB - The therapy of Crohn's disease is constantly evolving. It is widely recognized that clinical assessment does not stage disease activity accurately and that endoscopic healing is associated with improved long-term outcomes. Disease management is therefore transitioning to a new paradigm that includes direct assessment of disease severity (endoscopically in most patients), followed by assessment of mucosal healing. New approaches have helped optimize the use of the thiopurines, methotrexate and anti-TNF agents. Novel agents with different mechanisms of action are expanding our therapeutic armamentarium. The major challenge of the future will be to identify patient subgroups best suited to particular therapeutic approaches. In the meantime, studies of comparative effectiveness will be crucial in positioning therapies relative to each other.
KW - Anti-TNF antibodies
KW - Crohn's disease
KW - Immunomodulators
UR - http://www.scopus.com/inward/record.url?scp=84896692016&partnerID=8YFLogxK
U2 - 10.1007/s11894-014-0384-2
DO - 10.1007/s11894-014-0384-2
M3 - Review article
C2 - 24682780
AN - SCOPUS:84896692016
VL - 16
JO - Current Gastroenterology Reports
JF - Current Gastroenterology Reports
SN - 1522-8037
IS - 6
M1 - 384
ER -