The Evolution of Treatment Paradigms in Crohn's Disease: Beyond Better Drugs

Reena Khanna; Vipul Jairath; Brian G Feagan

doi:10.1016/j.gtc.2017.05.010

The Evolution of Treatment Paradigms in Crohn's Disease: Beyond Better Drugs

Gastroenterol Clin North Am. 2017 Sep;46(3):661-677. doi: 10.1016/j.gtc.2017.05.010.

Authors

Reena Khanna¹, Vipul Jairath², Brian G Feagan³

Affiliations

¹ Department of Medicine, University of Western Ontario, 100 Dundas Street, Suite 200, London, Ontario N6A 5B6, Canada.
² Department of Medicine, University of Western Ontario, 100 Dundas Street, Suite 200, London, Ontario N6A 5B6, Canada; Department of Epidemiology & Biostatistics, University of Western Ontario, 100 Dundas Street, Suite 200, London, Ontario N6A 5B6, Canada.
³ Department of Medicine, University of Western Ontario, 100 Dundas Street, Suite 200, London, Ontario N6A 5B6, Canada; Department of Epidemiology & Biostatistics, University of Western Ontario, 100 Dundas Street, Suite 200, London, Ontario N6A 5B6, Canada. Electronic address: brian.feagan@robartsinc.com.

PMID: 28838421
DOI: 10.1016/j.gtc.2017.05.010

Abstract

Despite advances in care, most patients with Crohn's disease (CD) develop complications, such as fistulas, or require surgery. Given the recent advances in drug therapy, an opportunity exists to optimize the management of this chronic disease through early use of effective therapies, clear definition of treatment targets, and application of the principles of personalized medicine. In this article, the authors discuss the evolution of treatment algorithms for CD to incorporate these strategies.

Keywords: Crohn's disease; Therapy; Treat to target; Treatment algorithms; Treatment paradigms.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Adrenal Cortex Hormones / therapeutic use
Algorithms*
Azathioprine / therapeutic use
Crohn Disease / drug therapy*
Gastrointestinal Agents / therapeutic use*
Humans
Immunosuppressive Agents / therapeutic use*
Infliximab / therapeutic use
Methotrexate / therapeutic use
Prognosis
Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

Adrenal Cortex Hormones
Gastrointestinal Agents
Immunosuppressive Agents
Tumor Necrosis Factor-alpha
Infliximab
Azathioprine
Methotrexate