摘要
克罗恩病(CD)是一种慢性的、致残的、渐进的和毁灭性的疾病。CD治疗的传统逐步策略的总体目标是治疗和控制症状。这一策略并没有改变病程并且现在被目标治疗法所替代。实现深度缓解(临床缓解和粘膜溃疡的缺乏)是2014年CD治疗的目标。诱导和维持深度缓解是防止诸如CD中肠道损伤和残疾等长期结果所需。诊断延迟是CD中常见的问题,与肠道损伤随时间风险增加有关。识别不良的预后因素、伴随“红旗”发展的风险分层,可能导致诸如抗肿瘤坏死因子药物的疾病修饰剂的早期干预,最终目的是防止过度治疗和避免处理不足。类似于风湿性关节炎,在CD早期抓住稍纵即逝的治疗机会,实现深度缓解,这是改变病程(住院、手术肠道损伤和残疾)和患者生活的最好途径。
关键词: 克罗恩病,早期疾病,炎症性肠道疾病,疗法
Current Drug Targets
Title:Catching the Therapeutic Window of Opportunity in Early Crohn`s Disease
Volume: 15 Issue: 11
Author(s): Silvio Danese, Gionata Fiorino, Carlos Fernandes and Laureal Peyrin-Biroulet
Affiliation:
关键词: 克罗恩病,早期疾病,炎症性肠道疾病,疗法
摘要: Crohn’s disease (CD) is a chronic, disabling, progressive and destructive disease. The general goal of conventional step-up strategy in CD treatment is to treat and control symptoms. This strategy did not change the disease course and is now being replaced with a treat-to-target approach. Achieving deep remission (clinical remission and absence of mucosal ulcerations) is the target in CD in 2014. Inducing and maintaining deep remission is needed to prevent long-term outcomes such as bowel damage and disability in CD. Diagnostic delay is a common issue in CD and is associated with an increased risk of bowel damage over time. Identification of poor prognostic factors, risk stratification together with the development of “red flags” may result in early intervention with disease-modifying agents such as anti-TNF agents with the final aim of preventing overtreatment and avoiding undertreatment. Similar to rheumatoid arthritis, by catching the therapeutic window of opportunity in early CD and achieving deep remission, this could be the best way to change disease course (hospitalizations, surgeries, bowel damage, and disability) and patients’ life.
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Danese Silvio, Fiorino Gionata, Fernandes Carlos and Peyrin-Biroulet Laureal, Catching the Therapeutic Window of Opportunity in Early Crohn`s Disease, Current Drug Targets 2014; 15 (11) . https://dx.doi.org/10.2174/1389450115666140908125738
DOI https://dx.doi.org/10.2174/1389450115666140908125738 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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