Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000049.xml
Download PDF
Clin Colon Rectal Surg 2007; 20(4): 269-281
DOI: 10.1055/s-2007-991026
DOI: 10.1055/s-2007-991026
Medical Management of Crohn's Disease
Further Information
Publication History
Publication Date:
16 October 2007 (online)
ABSTRACT
The clinical course of Crohn's disease (CD) is characterized by unpredictable phases of disease activity and quiescence. The majority of CD patients experience mild to moderate disease or are in clinical remission over significant periods during the course of their disease. These patients can be treated conservatively with 5-aminosalicylates or budesonide depending on the disease location. Those patients with more severe forms of the disease who require corticosteroids should be treated more aggressively with early introduction of immunomodulator and/or biologic therapy, which may help to prevent the complications associated with CD. It has been suggested that therapies directed at mucosal healing may favorably modify the natural history of CD. As newer, more effective medications become available and new therapeutic approaches are introduced (top-down therapy), mucosal healing, and not solely clinical remission, may well become the preferred treatment objective.
KEYWORDS
Crohn's disease - medical management
REFERENCES
- 1 Hanauer S B. Inflammatory bowel disease. N Engl J Med. 1996; 334 841-848
- 2 Loftus E V, Schoenfeld P, Sandborn W J. The epidemiology and natural history of Crohn's disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther. 2002; 16 51-60
- 3 Loftus C G, Loftus E V, Harmsen W S et al.. Update on the incidence and prevalence of Crohn's disease and ulcerative colitis in Olmsted County, Minnesota, 1940-2000. Inflamm Bowel Dis. 2007; 13 254-261
- 4 Bernstein C N. The epidemiology of inflammatory bowel disease in Canada: a population-based study. Am J Gastroenterol. 2006; 101 1559-1568
- 5 Persson P G, Bernell O, Leijonmarck C E, Farahmand B Y, Hellers G, Ahlbom A. Survival and cause-specific mortality in inflammatory bowel disease: a population-based cohort study. J Gastroenterol. 1996; 110 1339-1345
- 6 Binder V, Hendriksen C, Kreiner S. Prognosis in Crohn's disease-based on results from a regional patient group from the county of Copenhagen. Gut. 1985; 26 146-150
- 7 Munkholm P, Langholz E, Davidsen M, Binder V. Disease activity courses in a regional cohort of Crohn's disease patients. Scand J Gastroenterol. 1995; 30 699-706
- 8 Silverstein M D, Loftus E V, Sandborn W J et al.. Clinical course and costs of care for Crohn's disease: Markov model analysis of a population-based cohort. J Gastroenterol. 1999; 117 49-57
- 9 Cosnes J, Cattan S, Blain A et al.. Long-term evolution of disease behavior of Crohn's disease. Inflamm Bowel Dis. 2002; 8 244-250
- 10 Moum B, Ekbom A, Vatn M H et al.. Clinical course during the 1st year after diagnosis in ulcerative colitis and Crohn's disease. Results of a large, prospective population-based study in southeastern Norway, 1990-93. Scand J Gastroenterol. 1997; 32 1005-1012
- 11 Henriksen M, Jahnsen J, Lygren I et al.. The Ibsen Study Group. Clinical course in Crohn's disease: results of a five-year population-based follow-up study (the IBSEN study). Scand J Gastroenterol. 2007; 42 602-610
- 12 Sands B E, Arsenault J E, Rosen M J et al.. Risk of early surgery for Crohn's disease: implications for early treatment strategies. Am J Gastroenterol. 2003; 98 2712-2718
- 13 Bernell O, Lapidus A, Hellers G. Risk factors for surgery and postoperative recurrence in Crohn's disease. Ann Surg. 2000; 231 38-45
- 14 Agrez M V, Valente R M, Pierce W, Melton III L J, van Heerden J A, Beart Jr R W. Surgical history of Crohn's disease in a well-defined population. Mayo Clin Proc. 1982; 57 747-752
- 15 Carbonnel F, Macaigne G, Beaugerie L, Gendre J P, Cosnes J. Crohn's disease severity in familial and sporadic cases. Gut. 1999; 44 91-95
- 16 Best W R, Becktel J M, Singleton J W, Kern Jr F. Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. J Gastroenterol. 1976; 70 439-444
- 17 Hodgson H J, Mazlam M Z. Review article: assessment of drug therapy in inflammatory bowel disease. Aliment Pharmacol Ther. 1991; 5 555-584
- 18 Modigliani R, Mary J Y, Simon J F et al.. Clinical, biological, and endoscopic picture of attacks of Crohn's disease. Evolution on prednisolone. Groupe d'Etude Therapeutique des Affections Inflammatoires Digestives. J Gastroenterol. 1990; 98 811-818
- 19 Jorgensen L G, Fredholm L, Petersen P H et al.. How accurate are clinical activity indices for scoring of disease activity in inflammatory bowel disease (IBD)?. Clin Chem Lab Med. 2005; 43 403-411
- 20 Cellier C, Sahmoud T, Froguel E et al.. Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic Crohn's disease. A prospective multicentre study of 121 cases. The Groupe d'Etudes Therapeutiques des Affections Inflammatoires Digestives. Gut. 1994; 35 231-235
- 21 Hanauer S B, Sandborn W. Practice Parameters Committee of the American College of Gastroenterology. Management of CD in adults. Am J Gastroenterol. 2001; 96 635-643
- 22 Summers R W, Switz D M, Sessions Jr J T et al.. National Cooperative Crohn's Disease Study: results of drug treatment. J Gastroenterol. 1979; 77 847-869
- 23 Malchow H, Ewe K, Brandes J W et al.. European Cooperative Crohn's Disease Study (ECCDS): results of drug treatment. J Gastroenterol. 1984; 86 249-266
- 24 Van Hees P A, Van Lier H J, Van Elteren P H et al.. Effect of sulphasalazine in patients with active Crohn's disease: a controlled double-blind study. Gut. 1981; 22 404-409
- 25 Anthonisen P, Barany F, Folkenborg O et al.. The clinical effect of salazosulphapyridine (Salazopyrin R) in Crohn's disease. A controlled double-blind study. Scand J Gastroenterol. 1974; 9 549-554
- 26 Taffet S L, Das K M. Sulfasalazine. Adverse effects and desensitization. Dig Dis Sci. 1983; 28 833-842
- 27 Das K M, Eastwood M A, McManus J P, Sircus W. The metabolism of salicylazosulphapyridine in ulcerative colitis. I. The relationship between metabolites and the response to treatment in inpatients. Gut. 1973; 14 631-641
- 28 Gearry R B, Ajlouni Y, Nandurkar S, Iser J H, Gibson P R. 5-Aminosalicylic acid (mesalazine) use in Crohn's disease: a survey of the opinions and practice of Australian gastroenterologists. Inflamm Bowel Dis. 2007; 13 1009-1015
- 29 Tremaine W J, Schroeder K W, Harrison J M, Zinsmeister A R. A randomized, double-blind, placebo-controlled trial of the oral mesalamine (5-ASA) preparation, Asacol, in the treatment of symptomatic Crohn's colitis and ileocolitis. J Clin Gastroenterol. 1994; 19 278-282
- 30 Singleton J W, Hanauer S B, Gitnick G L et al.. Mesalamine capsules for the treatment of active Crohn's disease: results of a 16-week trial. Pentasa Crohn's Disease Study Group. J Gastroenterol. 1993; 104 1293-1301
- 31 Singleton J. Second trial of mesalamine therapy in the treatment of active Crohn's disease. J Gastroenterol. 1994; 107 632-633
- 32 Hanauer S B, Strömberg U. Oral Pentasa in the treatment of active Crohn's disease: a meta-analysis of double-blind, placebo-controlled trials. Clin Gastroenterol Hepatol. 2004; 2 379-388
- 33 Dahlberg E, Thalen A, Brattsand R et al.. Correlation between chemical structure, receptor binding, and biological activity in some novel, highly active, 16, 17-acetyl-substituted glucocorticoids. Mol Pharmacol. 1984; 25 70-78
- 34 Brattsand R. Overview of newer glucocorticosteroid preparations for inflammatory bowel disease. Can J Gastroenterol. 1990; 4 407-414
- 35 Kane S V, Schoenfeld P, Sandborn W J, Tremaine W, Hofer T, Feagan B G. The effectiveness of budesonide therapy for Crohn's disease. Aliment Pharmacol Ther. 2002; 16 1509-1517
- 36 Greenberg G R, Feagan B G, Martin F et al.. Oral budesonide for active Crohn's disease. Canadian Inflammatory Bowel Disease Study Group. N Engl J Med. 1994; 331 836-841
- 37 Tremaine W J, Hanauer S B, Katz S et al.. Budesonide CIR capsules (once or twice daily divided-dosage) in active Crohn's disease: a randomized placebo-controlled study in the United States. Am J Gastroenterol. 2002; 97 1748-1754
- 38 Thomsen O O, Cortot A, Jewell D et al.. A comparison of budesonide and mesalamine for active Crohn's disease. N Engl J Med. 1998; 339 370-374
- 39 Sutherland L, Singleton J, Sessions J et al.. Double blind, placebo controlled trial of metronidazole in Crohn's disease. Gut. 1991; 32 1071-1075
- 40 Allan R, Cooke W T. Evaluation of metronidazole in the management of Crohn's disease. Gut. 1977; 18 A422
- 41 Ambrose N S, Allan R N, Keighley M R et al.. Antibiotic therapy for treatment in relapse of intestinal Crohn's disease. A prospective randomized study. Dis Colon Rectum. 1985; 28 81-85
- 42 Blichfeldt P, Blomhoff J P, Myhre E et al.. Metronidazole in Crohn's disease. A double blind cross-over clinical trial. Scand J Gastroenterol. 1978; 13 123-127
- 43 Arnold G L, Beaves M R, Pryjdun V O et al.. Preliminary study of ciprofloxacin in active Crohn's disease. Inflamm Bowel Dis. 2002; 8 10-15
- 44 Steinhart A H, Feagan B G, Wong C J et al.. Combined budesonide and antibiotic therapy for active Crohn's disease: a randomized controlled trial. J Gastroenterol. 2002; 123 33-40
- 45 Prantera C, Lochs H, Campieri M et al.. Antibiotic treatment of Crohn's disease: results of a multicentre, double blind, randomized, placebo-controlled trial with rifaximin. Aliment Pharmacol Ther. 2006; 15(23) 1117-1125
- 46 Sandborn W J, Feagan B G. Review article: mild to moderate Crohns disease defining the basis for a new treatment algorithm. Aliment Pharmacol Ther. 2003; 18 263-277
- 47 Camma C, Giunta M, Rosselli M, Cottone M. Mesalamine in the maintenance treatment of Crohn's disease: a meta-analysis adjusted for confounding variables. J Gastroenterol. 1997; 113 1465-1473
- 48 Rijk M C, van Hogezand R A, van Lier H J, van Tongeren J H. Sulphasalazine and prednisone compared with sulphasalazine for treating active Crohn disease. A double-blind, randomized, multicenter trial. Ann Intern Med. 1991; 114 445-450
- 49 Greenberg G R, Feagan B G, Martin F et al.. Oral budesonide as maintenance treatment for Crohn's disease: a placebo-controlled, dosage-ranging study. Canadian Inflammatory Bowel Disease Study Group. J Gastroenterol. 1996; 110 45-51
- 50 Sandborn W J, Löfberg R, Feagan B G, Hanauer S B, Campieri M, Greenberg G R. Budesonide for maintenance of remission in patients with Crohn's disease in medically induced remission: a predetermined pooled analysis of four randomized, double-blind, placebo-controlled trials. Am J Gastroenterol. 2005; 100 1780-1787
- 51 Munkholm P, Langholz E, Davidsen M, Binder V. Frequency of glucocorticoid resistance and dependency in Crohn's disease. Gut. 1994; 35 360-362
- 52 Sands B E, Arsenault J E, Rosen M J et al.. Risk of early surgery for Crohn's disease: implications for early treatment strategies. Am J Gastroenterol. 2003; 98 2712-2718
- 53 Rutgeerts P, Löfberg R, Malchow H et al.. A comparison of budesonide with prednisolone for active Crohn's disease. N Engl J Med. 1994; 331 842-845
- 54 Ho G T, Chiam P, Drummond H, Loane J, Arnott I D, Satsangi J. The efficacy of corticosteroid therapy in inflammatory bowel disease: analysis of a 5-year UK inception cohort. Aliment Pharmacol Ther. 2006; 24 319-330
- 55 Faubion W A, Loftus E V, Harmsen W S, Zinsmeister A R, Sandborn W J. The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study. J Gastroenterol. 2001; 121 255-260
- 56 Sandborn W, Sutherland L, Pearson D, May G, Modigliani R, Prantera C. Azathioprine or 6-mercaptopurine for inducing remission of Crohn's disease. Cochrane Database Syst Rev. 2000; 2 CD000545
- 57 Present D H, Korelitz B I, Wisch N, Glass J L, Sachar D B, Pasternack B S. Treatment of Crohn‘s disease with 6-mercaptopurine. A long-term, randomized, double-blind study. N Engl J Med. 1980; 302 981-987
- 58 Pearson D C, May G R, Fick G H, Sutherland L R. Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis. Ann Intern Med. 1995; 123 132-142
- 59 Candy S, Wright J, Gerber M, Adams G, Gerig M, Goodman R. A controlled double-blind study of azathioprine in the management of Crohn's disease. Gut. 1995; 37 674-678
- 60 Ewe K, Press A G, Singe C C et al.. Azathioprine combined with prednisolone or monotherapy with prednisolone in active Crohn's disease. J Gastroenterol. 1993; 105 367-372
- 61 Markowitz J, Grancher K, Kohn N, Lesser M, Daum F. A multicenter trial of 6-mercaptopurine and prednisone in children with newly diagnosed Crohn's disease. J Gastroenterol. 2000; 119 895-902
- 62 Sandborn W J. A review of immune modifier therapy for inflammatory bowel disease: azathioprine, 6-mercaptopurine, cyclosporine, and methotrexate. Am J Gastroenterol. 1996; 91 423-433
- 63 Black A J, McLeod H L, Capell H A et al.. Thiopurine methyltransferase genotype predicts therapy-limiting severe toxicity from AZA. Ann Intern Med. 1998; 129 716-718
- 64 Colombel J F, Ferrari N, Debuysere H et al.. Genotypic analysis of thiopurine S-methyltransferase in patients with Crohn's disease and severe myelosuppression during azathioprine therapy. J Gastroenterol. 2000; 118 1025-1030
- 65 Campbell S, Kingstone K, Ghosh S. Relevance of thiopurine methyltransferase activity in inflammatory bowel disease patients maintained on low-dosage azathioprine. Aliment Pharmacol Ther. 2002; 16 389-398
- 66 Dubinsky M C, Lamothe S, Yang H Y et al.. Pharmacogenomics and metabolite measurement for 6-mercaptopurine therapy in inflammatory bowel disease. J Gastroenterol. 2000; 118 705-713
- 67 Regueiro M, Mardini H. Determination of thiopurine methyltransferase genotype or phenotype optimizes initial dosing of azathioprine for the treatment of Crohn's disease. J Clin Gastroenterol. 2002; 35 240-244
- 68 Winter J, Walker A, Shapiro D, Gaffney D, Spooner R J, Mills P R. Cost-effectiveness of thiopurine methyltransferase genotype screening in patients about to commence azathioprine therapy for treatment of inflammatory bowel disease. Aliment Pharmacol Ther. 2004; 20 593-599
- 69 Dubinsky M C, Reyes E, Ofman J, Chiou C F, Wade S, Sandborn W J. A cost-effectiveness analysis of alternative disease management strategies in patients with Crohn's disease treated with azathioprine or 6-mercaptopurine. Am J Gastroenterol. 2005; 100 2239-2247
- 70 Cummins D, Sekar M, Halil O, Banner N. Myelosuppression associated with azathioprine-allopurinol interaction after heart and lung transplantation. Transplantation. 1996; 61 1661-1662
- 71 Dubinsky M C, Yang H, Hassard P V et al.. 6-MP metabolite profiles provide a biochemical explanation for 6-MP resistance in patients with inflammatory bowel disease. J Gastroenterol. 2002; 122 904-915
- 72 Sparrow M P, Hande S A, Friedman S et al.. Allopurinol safely and effectively optimizes thioguanine metabolites in inflammatory bowel disease patients not responding to azathioprine and mercaptopurine. Aliment Pharmacol Ther. 2005; 22 441-446
- 73 Lémann M, Mary J Y, Colombel J F et al.. Groupe D'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif. A randomized, double-blind, controlled withdrawal trial in Crohn's disease patients in long-term remission on azathioprine. J Gastroenterol. 2005; 128 1812-1818
- 74 Chebli J M, Gaburri P D, De Souza A F et al.. Long-term results with azathioprine therapy in patients with corticosteroid-dependent Crohn's disease: open-label prospective study. J Gastroenterol Hepatol. 2007; 22 268-274
- 75 Korelitz B I, Mirsky F J, Fleisher M R, Warman J I, Wisch N, Gleim G W. Malignant neoplasms ubsequent to treatment of inflammatory bowel disease with 6-mercaptopurine. Am J Gastroenterol. 1999; 94 3248-3253
- 76 Farrell R J, Ang Y, Kileen P et al.. Increased incidence of non-Hodgkin's lymphoma in inflammatory bowel disease patients on immunosuppressive therapy but overall risk is low. Gut. 2000; 47 514-519
- 77 Feagan B G, Rochon J, Fedorak R N et al.. MTX for the treatment of Crohn's disease. The North American Crohn's Study Group Investigators. N Engl J Med. 1995; 332 292-297
- 78 Oren R, Arber N, Odes S et al.. Methotrexate in chronic active ulcerative colitis: a double-blind, randomized, Israeli multicenter trial. J Gastroenterol. 1996; 110 1416-1421
- 79 Arora S, Katkov W, Cooley J et al.. Methotrexate in Crohn's disease: results of a randomized, double-blind, placebo-controlled trial. J Gastroenterol Hepatol. 1999; 46 1724-1729
- 80 Feagan B G, Fedorak R N, Irvine E J et al.. A comparison of methotrexate with placebo for the maintenance of remission in Crohn's disease. North American Crohn's Study Group Investigators. N Engl J Med. 2000; 342 1627-1632
- 81 Schröder O, Stein J. Low dosage methotrexate in inflammatory bowel disease: current status and future directions. Am J Gastroenterol. 2003; 98 530-537
- 82 Roenigk Jr H H, Auerbach R, Maibach H et al.. Methotrexate in psoriasis: Revised guidelines. J Am Acad Dermatol. 1988; 19 145-156
- 83 Van Ede A E, Laan RFJM, Blom H J et al.. Methotrexate in rheumatoid arthritis: an update with focus on mechanisms involved in toxicity. Semin Arthritis Rheum. 1998; 27 277-292
- 84 Targan S R, Hanauer S B, van Deventer S J et al.. A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn's disease. Crohn's Disease cA2 Study Group. N Engl J Med. 1997; 337 1029-1035
- 85 Rutgeerts P, D'Haens E R, Targan S R et al.. Efficacy and safety of retreatment with anti-tumour necrosis factor antibody to maintain remission in Crohn's disease. J Gastroenterol. 1999; 117 761-769
- 86 Hanauer S B, Feagan B G, Lichtenstein G R et al.. Maintenance infliximab for Crohn's disease: the ACCENT 1 randomised trial. Lancet. 2002; 359 1541-1549
- 87 Sandborn W J, Hanauer S B. Infliximab in the treatment of Crohn's disease: a user's guide for clinicians. Am J Gastroenterol. 2002; 97 2962-2972
- 88 Cohen R D. Efficacy and safety of repeated infliximab infusions for Crohn's disease: 1-year clinical experience. Inflamm Bowel Dis. 2001; 7(Suppl 1) S17-S22
- 89 Baert F, Noman M, Vermeire S et al.. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med. 2003; 348 601-608
- 90 Sandborn W J, Loftus E V. Balancing the risks and benefits of infliximab in the treatment of inflammatory bowel disease. Gut. 2004; 53 780-782
- 91 Keane J, Gershan S, Wise R P. Tuberculosis associated with infliximab, a tumour necrosis factor-α neutralizing agent. N Engl J Med. 2001; 345 1098-1104
- 92 Madonia S, Orlando A, Scimeca D, Olivo M, Rossi F, Cottone M. Occult hepatitis B and infliximab-induced HBV reactivation. Inflamm Bowel Dis. 2007; 13 508-509
- 93 Esteve M, Saro C, González-Huix F, Suarez F, Forné M, Viver J M. Chronic hepatitis B reactivation following infliximab therapy in Crohn's disease patients: need for primary prophylaxis. Gut. 2004; 53 1363-1365
- 94 Bebb J R, Logan R P. Review article: does the use of immunosuppressive therapy in inflammatory bowel disease increase the risk of developing lymphoma?. Aliment Pharmacol Ther. 2001; 15 1843-1849
- 95 Colombel J F, Loftus E V, Tremaine W J et al.. The safety profile of infliximab in patients with Crohn's disease: the Mayo clinic experience in 500 patients. J Gastroenterol. 2004; 126 19-31
- 96 Lichtenstein G R, Feagan B G, Cohen R D et al.. Serious infections and mortality in association with therapies for Crohn's disease: TREAT registry. Clin Gastroenterol Hepatol. 2006; 4 621-630
- 97 Belhadj K, Reyes F, Farcet J P et al.. Hepatosplenic gamma delta T-cell lymphoma is a rare clinicopathologic entity with poor outcome: report on a series of 21 patients. Blood. 2003; 102 4261-4269
- 98 Hanauer S B, Sandborn W J, Rutgeerts P et al.. Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn's disease: the CLASSIC I trial. Gastroenterology. 2006; 130 323-333
- 99 Sandborn W J, Hanauer S B, Lukas M et al.. Maintenance of remission over 1 year in patients with active Crohn's disease treated with adalimumab: results of a blinded, placebo-controlled trial. Am J Gastroenterol. 2005; 100 843
- 100 Colombel J, Sandborn W J, Rutgeerts P et al.. Adalimumab induces and maintains clinical response and remission in patients with active Crohn's disease: results of the CHARM trial. J Gastroenterol. 2006; 130 Abstract 686d
- 101 Sandborn W J, Feagan B G, Stoinov S et al.. Certolizumab pegol administered subcutaneously is effective and well tolerated in patients with active Crohn's disease: results from a 26-week, placebo-controlled Phase III study (PRECISE 1). J Gastroenterol. 2006; 130 A-107
- 102 Schreiber S, Khaliq-Kareemi M, Lawrance I C et al.. Maintenance therapy with certolizumab pegol for Crohn's disease. N Engl J Med. 2007; 357 239-250
- 103 Hanauer S B, Colombel J F, Sandborn W J, Panes J, McColm J A, Schreiber S. Subcutaneous certolizumab pegol is effective in anti-TNF naive patients and patients with prior infliximab use. Am J Gastroenterol. 2006; 101 Abstract 36B
- 104 Gordon F H, Lai C W, Hamilton M I et al.. A randomized placebo-controlled trial of a humanized monoclonal antibody to alpha4 integrin in active Crohn's disease. J Gastroenterol. 2001; 121 268-274
- 105 Ghosh S, Goldin E, Gordon F H et al.. Natalizumab for active Crohn's disease. N Engl J Med. 2003; 348 24-32
- 106 Sandborn W J, Colombel J F, Enns R et al.. Natalizumab induction and maintenance therapy for Crohn's disease. N Engl J Med. 2005; 353 1912-1925
- 107 Langer-Gould A, Atlas S W, Green A J, Bollen A W, Pelletier D. Progressive multifocal leukoencephalopathy in a patient treated with natalizumab. N Engl J Med. 2005; 353 375-381
- 108 Kleinschmidt-DeMasters B K, Tyler K L. Progressive multifocal leukoencephalopathy complicating treatment with natalizumab and interferon beta-1a for multiple sclerosis. N Engl J Med. 2005; 353 369-374
- 109 Van Assche G, Van Ranst M, Sciot R et al.. Progressive multifocal leukoencephalopathy after natalizumab therapy for Crohn's disease. N Engl J Med. 2005; 353 362-368
- 110 Yousry T A, Habil M, Major E O et al.. Evaluation of patients treated with natalizumab for progressive multifocal leukoencephalopathy. N Engl J Med. 2006; 354 924-933
- 111 Faubion W A, Loftus E V, Harmsen W S, Zinsmeister A R, Sandborn W J. The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study. J Gastroenterol. 2001; 121 255-260
- 112 Rutgeerts P, Diamond R H, Bala M et al.. Scheduled maintenance treatment with infliximab is superior to episodic treatment for the healing of mucosal ulceration associated with Crohn's disease. Gastrointest Endosc. 2006; 63 433-442
- 113 Hommes D W, Baert F, van Assche G et al.. Management of recent onset Crohn's disease: a controlled randomized trial comparing step-up and top-down therapy. J Gastroenterol. 2005; 128(Suppl 2) A577
- 114 D'Haens G, Geboes K, Rutgeerts P. Endoscopic and histologic healing of Crohn's (ileo-) colitis with azathioprine. Gastrointest Endosc. 1999; 50 667-671
- 115 D'Haens G, Geboes K, Ponette E et al.. Healing of severe recurrent ileitis with azathioprine therapy in patients with Crohn's disease. J Gastroenterol. 1997; 112 475-481
- 116 Chun A, Chadi R M, Korelitz B I et al.. Intravenous corticotrophin vs hydrocortisone in the treatment of hospitalized patients with Crohn's disease: a randomized double-blind study and follow up. Inflamm Bowel Dis. 1998; 4 177-181
- 117 Felder J B, Adler D J, Korelitz B I. The safety of corticosteroid therapy in crohn's disease with an abdominal mass. Am J Gastroenterol. 1991; 86 1450-1455
- 118 Egan L J, Sandborn W J, Tremaine W J. Clinical outcome following treatment of refractory inflammatory and fistulizing Crohn's disease with intravenous cyclosporine. Am J Gastroenterol. 1998; 93 442-448
- 119 Feagan B G. 5-ASA therapy for active Crohn's disease: old friends, old data, and a new conclusion. Clin Gastroenterol Hepatol. 2004; 2 376-378
- 120 Regueiro M, Mardini H. Treatment of perianal fistulizing Crohn's disease with infliximab alone or as an adjunct to exam under anesthesia with Seton placement. Inflamm Bowel Dis. 2003; 9 98-103
- 121 Bernstein L H, Frank M S, Brandt L J, Boley S J. Healing of perineal Crohn's disease with metronidazole. J Gastroenterol. 1980; 79 357-365
- 122 Jakobovits J, Schuster M M. Metronidazole therapy for Crohn's disease and associated fistulae. Am J Gastroenterol. 1984; 79 533-540
- 123 Brandt L J, Bernstein L H, Boley S J, Frank M S. Metronidazole therapy for perineal Crohn's disease: a follow-up study. J Gastroenterol. 1982; 83 383-387
- 124 Solomon M J, McLeod R S, O'Connor B I, Steinhart A H, Greenberg G R, Cohen Z. Combination ciprofloxacin and metronidazole in severe perianal Crohn's disease. Can J Gastroenterol. 1993; 7 571-573
- 125 Sands B E, Anderson F H, Bernstein C N et al.. Infliximab maintenance therapy for fistulizing Crohn's disease. N Engl J Med. 2004; 350 876-885
- 126 Pearson D C, May G R, Fick G H, Sutherland L R. Azathioprine and 6-mercaptopurine in Crohn's disease. A meta-analysis. Ann Intern Med. 1995; 123 132-142
- 127 Korelitz B I, Present D H. Favorable effect of 6-mercaptopurine on fistulae of Crohn's disease. Dig Dis Sci. 1985; 30 58-64
- 128 O'Brien J, Bayless T, Bayless J. Use of azathioprine in the treatment of Crohn's disease. J Gastroenterol. 1991; 101 39-46
- 129 Greenstein A J, Present D, Sachar D et al.. Gastric fistulas in Crohn's disease. Report of cases. Dis Colon Rectum. 1989; 32 888-892
- 130 Margolin M L, Korelitz B. Management of bladder fistula in Crohn's disease. J Clin Gastroenterol. 1989; 11 399-402
- 131 Glass R E, Ritchie J K, Lennard-Jones J E, Hawley P R, Todd I P. Internal fistulas in Crohn's disease. Dis Colon Rectum. 1985; 28 557-561
- 132 Present D H, Rutgeerts P, Targan S et al.. Infliximab for the treatment of fistulas in patients with Crohn's disease. N Engl J Med. 1999; 340 1398-1405
- 133 Sands B E, Blank M A, Patel K, van Deventer SJH. Long-term treatment of rectovaginal fistulas in Crohn's disease: response to infliximab in the ACCENT II study. Clin Gastroenterol Hepatol. 2004; 2 912-920
- 134 Wise P E, Schwartz D A. Management of perianal Crohn's disease. Clin Gastroenterol Hepatol. 2006; 4 426-430
- 135 Topstad D R, Panaccione R, Heine J A, Johnson D R, MacLean A R, Buie W D. Combined Seton placement, infliximab infusion, and maintenance immunosuppressives improve healing rate in fistulizing anorectal Crohn's disease: a single center experience. Dis Colon Rectum. 2003; 46 577-583
- 136 Rutgeerts P, Geboes K, Vantrappen G, Beyls J, Kerremans R, Hiele M. Predictability of postoperative course of Crohn's disease. J Gastroenterol. 1990; 99 956-963
- 137 Whelan G, Farmer R G, Fazio V W, Goormastic M. Recurrence after surgery in Crohn's disease. Relationship to location of disease (clinical pattern) and surgical indication. J Gastroenterol. 1985; 88 1826-1833
- 138 Mekhjian H S, Switz D M, Watts H D, Deren J J, Katon R M, Beman F M. National Cooperative Crohn's Disease Study: factors determining recurrence of Crohn's disease after surgery. J Gastroenterol. 1979; 77 907-913
- 139 Yamamoto T. Factors affecting recurrence after surgery for Crohn's disease. World J Gastroenterol. 2005; 11 3971-3979
- 140 Ryan W R, Allan R N, Yamamoto T, Keighley M R. Crohn's disease patients who quit smoking have a reduced risk of reoperation for recurrence. Am J Surg. 2004; 187 219-225
- 141 Polle S W, Slors J F, Weverling G J, Gouma D J, Hommes D W, Bemelman W A. Recurrence after segmental resection for colonic Crohn's disease. Br J Surg. 2005; 92 1143-1149
- 142 Lochs H, Mayer M, Fleig W E et al.. Prophylaxis of postoperative relapse in Crohn's disease with mesalamine: European Cooperative Crohn's Disease Study VI. J Gastroenterol. 2000; 118 264-273
- 143 Rutgeerts P, Hiele M, Geboes K et al.. Controlled trial of metronidazole treatment for prevention of Crohn recurrence after ileal resection. J Gastroenterol. 1995; 108 1617-1621
- 144 Hanauer S B, Korelitz B I, Rutgeerts P et al.. Postoperative maintenance of Crohn's disease remission with 6-mercaptopurine, mesalamine, or placebo: a 2-year trial. J Gastroenterol. 2004; 127 723-729
- 145 Ardizzone S, Maconi G, Sampietro G M et al.. Azathioprine and mesalamine for prevention of relapse after conservative surgery for Crohn's disease. J Gastroenterol. 2004; 127 730-740
Jamie S BarkinM.D.
Division of Gastroenterology, Mount Sinai Medical Center
4300 Alton Rd., Ste. 2522, Miami Beach, FL 33140
Email: jamiebarkin@msmc.com