Inflammatory bowel disease: clinical aspects/established & evolving therapies.

[Guest guest]

Lancet. 2007 May 12;369(9573):1641-57.

Inflammatory

bowel disease: clinical aspects and established and evolving therapies.

Baumgart DC, Sandborn WJ.

Department of Medicine, Division of Gastroenterology and Hepatology, Medical School

of the Humboldt-University of Berlin,

Germany.

Crohn's disease and ulcerative colitis are two idiopathic inflammatory bowel

disorders. In this paper we discuss the current

diagnostic approach, their pathology, natural course, and common complications,

the assessment of disease activity, extraintestinal

manifestations, and medical and surgical management, and provide diagnostic and

therapeutic algorithms. We critically review the

evidence for established (5-aminosalicylic acid compounds, corticosteroids, immunomodulators, calcineurin

inhibitors) and emerging novel therapies--including biological therapies--directed

at cytokines (eg, infliximab,

adalimumab, certolizumab pegol) and receptors (eg, visilizumab, abatacept) involved

in T-cell activation, selective adhesion molecule blockers (eg,

natalizumab, MLN-02, alicaforsen),

anti-inflammatory cytokines (eg, interleukin 10),

modulation of the intestinal flora (eg, antibiotics, prebiotics, probiotics), leucocyte apheresis and many more

monoclonal antibodies, small molecules, recombinant growth factors, and MAP kinase inhibitors targeting various inflammatory cells and

pathways. Finally, we summarise the practical aspects

of standard therapies including dosing, precautions, and side-effects. PMID: 17499606 [PubMed

- in process]

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (33) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas