Display Settings:

Format

Send to:

Choose Destination

    Aliment Pharmacol Ther. 2008 Jan 1;27(1):11-8. Epub 2007 Oct 5.

    Review article: the evidence base for interventions used to maintain remission in Crohn's disease.

    Akobeng AK.

    Department of Paediatric Gastroenterology, Booth Hall Children's Hospital, Central Manchester and Manchester Children's University Hospitals, Manchester, UK. tony.akobeng@cmmc.nhs.uk

    Comment in:

    BACKGROUND: Crohn's disease is characterised by recurrent flare-ups alternating with periods of remission. A number of interventions are currently used in clinical practice to try and maintain remission in Crohn's disease but the evidence base for some of them may be questionable. AIM: To review the available evidence on interventions, which are currently used to maintain remission in Crohn's disease. METHODS: The Cochrane Library and Medline (Pubmed) were searched for level 1 evidence on specific interventions. Search terms included 'Crohn's disease or synonyms', 'remission or synonyms' and the names of specific interventions. RESULTS: Azathioprine, infliximab and adalimumab are effective at maintaining remission in Crohn's disease. Natalizumab is also effective, but there are concerns about its potential association with progressive multifocal leukoencephalopathy. Long-term enteral nutritional supplementation, enteric-coated omega-3 fatty acids and intramuscular methotrexate may also be effective but the evidence for these is based on relatively small studies. The available evidence does not support the use of oral 5-aminosalicylates agents, corticosteroids, anti-mycobacterial agents, probiotics or ciclosporin as maintenance therapy in Crohn's disease. CONCLUSION: A better understanding of the evidence base of existing interventions could result in the use of treatments, which are more likely to lead to improved patient outcomes.

    PMID: 17919275 [PubMed - indexed for MEDLINE]

    Supplemental Content

    Click here to read

    Patient drug information

    • Methotrexate (Rheumatrex®, Trexall®)

      Methotrexate is used to treat severe psoriasis (a skin disease in which red, scaly patches form on some areas of the body) that cannot be controlled by other treatments. Methotrexate is also used along with rest, physica...

    • Mercaptopurine (Purinethol®)

      Your doctor has ordered the drug mercaptopurine to help treat your illness. The drug is taken by mouth in tablet form.

    • Azathioprine (Azasan®, Imuran®)

      Azathioprine is used with other medications to prevent rejection of kidney transplants. It is also used to treat severe rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain and swellin...

    • » See all 4 drug reports ...