Crohn's disease: current treatment options

2008 ◽  
Vol 93 (9) ◽  
pp. 787-792 ◽  
Author(s):  
A K Akobeng
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Treatment Options ◽  
Current Treatment

scholarly journals Current Overview on the Use of Mesenchymal Stem Cells for Perianal Fistula Treatment in Patients with Crohn’s Disease

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1133
Author(s):  
Marcin Włodarczyk ◽  
Katarzyna Czerwińska ◽  
Jakub Włodarczyk ◽  
Jakub Fichna ◽  
Adam Dziki ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Treatment Options ◽  
Perianal Fistula ◽  
Current Treatment ◽  
Culture Conditions ◽  
Optimal Dosage ◽  
Number Of Patients

Perianal fistula in patients with Crohn’s disease is an extremely challenging condition. The disease tends to reoccur, and with current treatment options, a large number of patients are left with active ailment and experience major morbidity. In recent years, hopeful results regarding local use of mesenchymal stem cells (MSCs) in perianal Crohn’s disease have been published. Although to this day there are no clear guidelines determining optimal dosage, injections frequency and culture conditions, their efficiency has proven to be much higher than conventionally used methods. According to studies, they can effectively induce as well as maintain fistula closure. This approach also avoids common side effects related to conventional surgical treatment.

scholarly journals Practical Medical Management of Crohn’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Bulent Baran ◽  
Cetin Karaca
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Disease ◽  
Clinical Judgment ◽  
Medical Management ◽  
Management Strategy ◽  
Treatment Options ◽  
Chronic Inflammatory Disease ◽  
Current Treatment ◽  
Proper Diagnosis

Crohn’s disease is a chronic inflammatory disease of diagnostic and therapeutic challenges. After proper diagnosis, treatment decisions must be made on precise clinical judgment. During the course of the disease there are variable clinical features, so each case must be managed individually. Physicians who care for patients with Crohn’s disease should be prepared for treatment options in different states of the disease and possible complications of both the disease and medications. This paper will focus on the management of Crohn’s disease. We aim to discuss current treatment options in different presentations of the disease and to provide algorithmic management strategy.

scholarly journals Nutritional Management of Paediatric Crohn’s Disease

2020 ◽  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Healthcare Professionals ◽  
Treatment Options ◽  
Current Treatment ◽  
Dietary Interventions ◽  
Treatment Needs ◽  
Three Phase ◽  
Dietary Components

For many people with Crohn’s disease (CD), onset occurs in childhood or adolescence. Treatment for CD has moved from predominantly surgical to, more often, pharmacological. While successful for many, others have tried various medications and combinations without long-term success and, for all, drug treatment needs to be balanced with potential therapy risks. Findings that diet can impact pathogenesis of CD to cause and exacerbate symptoms have inspired studies of dietary interventions. The Crohn’s Disease Exclusion Diet (CDED) was developed following the observation that certain dietary components were linked to inflammation and gut dysbiosis found in those with CD. This three-phase diet included two periods of a highly-controlled and prescribed diet, followed by a maintenance diet in which patients had a wider choice of foods. The diet limited ingestion of foods that may trigger inflammation and/or dysbiosis in CD, such as saturated fats, wheat, carrageenan, and some dairy products, and included healthy choices, such as fruits, vegetables, lean protein sources, and complex carbohydrates. It was nutritionally balanced, science-based, and included foods that were widely accessible. Based on findings from clinical trials and case studies, four experts (Prof Lionetti, Prof Martín-de-Carpi, Mrs Sigall-Boneh, and Prof Wine) discussed the background of CD, current treatment options, the utility of dietary therapies including CDED, and how all healthcare professionals (HCP) looking after children and adolescents with CD should consider the use of diet as part of their therapy.

TREATMENT PATTERNS OF NEWLY DIAGNOSED PEDIATRIC ULCERATIVE COLITIS AND CROHN’S DISEASE PATIENTS IN THE IMPROVECARENOW REGISTRY

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S22-S23
Author(s):  
Theresa Hunter ◽  
Wendy Komocsar ◽  
Richard Colletti ◽  
Chunyan Liu ◽  
Keith Benkov ◽  
...  
Keyword(s):  
United States ◽  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
The United States ◽  
Current Treatment ◽  
Treatment Patterns ◽  
Initial Visit ◽  
Newly Diagnosed ◽  
Time Points

Abstract Objectives The objective of this study was to assess current treatment patterns of pediatric ulcerative colitis (UC) and Crohn’s disease (CD) patients, using data in the ImproveCareNow (ICN) registry. Methods Pediatric (2–17 years) patients in the United States who were newly diagnosed with UC or CD between June 1, 2013-December 31, 2019, who had their first recorded ICN visit within 6 months of diagnosis and who were actively followed for at least 12 months (± 90 days) were included in this study. Descriptive statistics of baseline patient demographics were summarized for the overall IBD patient population and separately for UC and CD. Treatment patterns (including use of corticosteroids, 5-aminosalicylic acid (5-ASA), 6-mercaptopurine/azathioprine (6-MP/AZA), methotrexate, tumor necrosis factor inhibitors (TNFi) [adalimumab, infliximab, certolizumab, golimumab, and their biosimilars], ustekinumab, vedolizumab, and other medications [natalizumab and tofacitinib]) were assessed at the initial baseline visit, and at 1-year and 3-year time points. Results A total of 6,504 pediatric IBD patients (UC=1,784; CD=4,720) were included in this study. Patients had a mean age at diagnosis of 13.0 years (UC=13.2; CD=12.9), 57.1% were male (UC=49.6%; CD=60.0%), and 81.0% were White (UC=81.2%; CD=81.0%) (Table 1). At the initial ICN visit, 46.4% of UC patients were prescribed a corticosteroid, while 19.8% received a 5-ASA, 12.6% received a TNFi, 10.4% received a 6-MP/AZA, 3.0% received methotrexate, and 0.3% received vedolizumab. At the initial visit, 40.2% of CD patients were prescribed a corticosteroid, while 29.1% received a TNFi, 18.5% received a 6-MP/AZA, 12.4% received methotrexate, and 3.3% received a 5-ASA. At the 1-year and 3-year time points, rates of 5-ASA and corticosteroid use decreased among UC patients; however, rates of 6-MP/AZA, methotrexate, and TNFi increased (Table 2). Similarly, at the 1-year and 3-year time points, rates of corticosteroids among CD patients decreased; however, rates of methotrexate and TNFi increased (Table 2). There was also an increase in use of ustekinumab and vedolizumab over time among UC and CD patients. Conclusion These results highlight the current treatment patterns of pediatric UC and CD patients in the United States. At the initial ICN visit, the 46% of UC and 40% of CD patients were receiving corticosteroids, however, at 1-year and 3-years after initial visit, over 30% of UC patients and over 60% of CD patients were receiving TNF inhibitors with considerably reduced corticosteroid use.

scholarly journals Vascular anomalies in the mesenteric circulation of patients with Crohn’s disease: a pilot study

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Matilde Zamboni ◽  
Maria Grazia Sibilla ◽  
Roberto Galeotti ◽  
Massimo Pedriali ◽  
Simona Ascanelli
Keyword(s):  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Vascular System ◽  
Current Treatment ◽  
Small Sample ◽  
Vascular Anomalies ◽  
Chronic Inflammatory Bowel Disease ◽  
Mesenteric Circulation ◽  
Inflammatory Bowel

Crohn’s disease (CD) is a chronic inflammatory bowel disease and its pathogenesis is still not well understood. Previous studies suggested the possibility of the involvement of vascular system, but, todate, the mesenteric circulation has poor been investigated, especially in complicated CD cases requiring colectomy. We investigated the mesenteric circulation in a case-control pilot study, including 19 controls and 7 patients affected by complicated cases of CD. Cases and controls underwent selective angiography of both superior and inferior mesenteric district. Transit time was found either significantly shortened in 2/7 cases (29%), or prolonged 5/7 (71%) (P=0.0034 in the superior mesenteric district; P=0.0079 in the inferior mesenteric district), respectively due to the presence of A-V malformations and of a miscellaneous of venous abnormalities, which included thrombosis, hypoplasia and extra-truncular venous malformations. Our study demonstrates the presence of congenital or acquired vascular anomalies in a small sample of CD patients not responder to current treatment and with severe complications. The present pilot study warrants further investigations.

scholarly journals P451 Short-and long-term effectiveness of ustekinumab in patients with Crohn’s disease: real-world data from a German IBD cohort

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S405-S405
Author(s):  
A Kubesch ◽  
L Rueter ◽  
K Farrag ◽  
T Krause ◽  
K Stienecker ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Real World ◽  
Treatment Options ◽  
Real World Data ◽  
Free Response ◽  
Faecal Calprotectin ◽  
Short And Long Term

Abstract Background The IL-12/23 inhibitor ustekinumab (UST) opened up new treatment options for patients with Crohn’s disease (CD). Due to the recent approval, Real-World German data on long-term efficacy and safety are lacking. This study aimed to assess the clinical course of CD patients under UST therapy and to identify potential predictive markers. Methods Patients with CD receiving UST treatment in three hospitals and two outpatient centres were included and retrospectively analysed. Rates for short- and long-term remission and response were analysed with the help of clinical (Harvey–Bradshaw Index [HBI]) and biochemical (C-reactive protein [CRP], faecal calprotectin [fCal]) parameters for disease activity. Results Data from 180 patients were evaluated. One hundred six patients had a follow-up of at least 8 weeks and were included. 96.2% of the patients were pre-exposed to anti- TNFα agents and 34.4% to both anti-TNFα and anti-integrin. The median follow-up was 49.1 weeks (95% CI 42.03–56.25). At week 8, 51 patients (54.8%) showed response to UST, and 24 (24.7%) were in remission. At week 48, 39 (41.9%) responded to UST, and 20 patients (21.5%) were in remission. Steroid-free response and remission at week eight were achieved by 30.1%, and 19.3% of patients. At week 48, 26.9% showed steroid-free response to UST, and 15.1% of the initial patient population was in steroid-free remission. Clinical response at week 16 was independently associated with remission at week 48. Conclusion Our study confirms short- and long-term UST effectiveness and tolerability in a cohort of multi-treatment exposed patients.

scholarly journals Upper Gastrointestinal Tract Crohn's Disease

1990 ◽  
Vol 4 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Hugh J Freeman
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Treatment Options ◽  
Upper Gastrointestinal Tract ◽  
Distal Intestine ◽  
The Subject ◽  
Atypical Presentations ◽  
Upper Gastrointestinal

Crohn's disease may involve any site within the gastrointestinal tract. Usually pathology is present in the ileum and/or colon, but atypical presentations may occur with apparently 'isolated' involvement of the oropharynx, esophagus or gastroduodenum. If changes typical of Crohn's disease are detected in the upper gastrointestinal tract, then a careful assessment is required involving radiographic, endoscopic and histologic studies to determine if pathology is present in more distal intestine. In addition , microbiologic studies may be important to exclude infectious causes, especially of granulomas. If these studies are negative, prolonged follow-up may be required to establish a diagnosis of Crohn's disease. Although upper gastrointestinal involvement is increasingly recognized as a significant cause of morbidity in Crohn's disease, the treatment options are limited , largely anecdotal and need to be the subject of detailed epidemiologic investigation and clinical trials.

scholarly journals Addressing current treatment challenges in Crohn's disease in real life: A physician's survey

2014 ◽  
Vol 46 (12) ◽  
pp. 1066-1071 ◽  
Author(s):  
Stephan R. Vavricka ◽  
Sanja Radivojevic ◽  
Christine N. Manser ◽  
Pascal Frei ◽  
Emanuel Burri ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Real Life ◽  
Current Treatment

scholarly journals Current Use of EEN in Pre-Operative Optimisation in Crohn’s Disease

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4389
Author(s):  
Sharafaath Shariff ◽  
Gordon Moran ◽  
Caris Grimes ◽  
Rachel Margaret Cooney
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Patient Outcomes ◽  
Surgical Procedures ◽  
Treatment Options ◽  
Paediatric Population ◽  
Mucosal Healing ◽  
Bowel Surgery ◽  
Operative Complications

Despite the increasing array of medications available for the treatment of Crohn’s disease and a focus on mucosal healing, approximately 35% of patients with Crohn’s disease undergo bowel surgery at some stage. The importance of nutritional optimisation before Crohn’s surgery is well-highlighted by surgical, nutritional, and gastroenterological societies with the aim of reducing complications and enhancing recovery. Surgical procedures are frequently undertaken when other treatment options have been unsuccessful, and, thus, patients may have lost weight and/or required steroids, and are therefore at higher risk of post-operative complications. EEN is used extensively in the paediatric population to induce remission, but is not routinely used in the induction of remission of adult Crohn’s disease or in pre-operative optimisation. Large prospective studies regarding the role of pre-operative EEN are lacking. In this review, we evaluate the current literature on the use of EEN in pre-operative settings and its impact on patient outcomes.

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