Maintenance therapy for Crohn’s disease

Abstract

Crohn's disease (CD) is a chronic, persistent, and destructive disorder with different forms of clinical behavior and the disease appears to be progressive over the long term. Providing greater levels of mucosal healing and resolution of clinical symptoms may modify the course of CD. This will often necessitate long-term therapy with immunosuppressant or biological therapies. Both these classes of drugs have side-effects and the latter are also very expensive. Identification of a subgroup of patients with a low risk of relapse and validation of the relevant predictors in various cohort studies are the key points to be able to cease immunosuppressant and/or biological therapy in patients with CD in stable remission. The individual parameters 'mucosal healing', 'deep remission', 'fecal calprotectin', and 'C-reactive protein' or various combinations of these parameters seem to be promising tools for predicting successful withdrawal of maintenance therapy.

Discontinuation of Scheduled Infliximab in Crohn’s Patients With Clinical Remission: A Retrospective Single-Center Study

“…Moreover, with the introduction of biological therapies for IBD, the therapeutic target for CD has changed from clinical remission to MH, even deep remission [30]. Even no consensus has been achieved in terms of defining MH and DR in IBD, anti-TNF-induced MH and DR has been demonstrated to prolong remission and reduce rate of complications, hospitalizations and surgery [26, 27, 31].…”

The value of big data in health

“…Belirlenmiş hedeflere yönelik üretilen mono-klonal antikor kullanı-mının yaygınlaşması ile oldukça pahalı ve yeni tedaviler kullanıma girmektedir. Bu sayede, özellikle kanserde veya Crohn hastalığı gibi kronik inflamatuvar hastalıklarda çok sayıda ümit vadeden ilaç geliştirilmektedir [11,12]. Ancak bu yeni ilaç grubu, ilgili tanıya sahip her hastaya verilmemekte, sadece belirli alt gruplara dahil olan, ortak bir genetik zemine veya epigenetik ortama sahip hastalar için uygun görülmektedir.…”