Which patients with inflammatory bowel disease should receive combination therapy?

被引：5

作者：

Cross, Raymond K. ^{[1
]}

机构：

[1] Univ Maryland, Dept Med, Div Gastroenterol & Hepatol, Baltimore, MD 21201 USA

来源：

EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY | 2015年 / 9卷 / 06期

关键词：

biologic therapy; Crohn's disease; decision making; immune suppressive agents; inflammatory bowel disease; TNF-alpha; ulcerative colitis; CROHNS-DISEASE; ULCERATIVE-COLITIS; RANDOMIZED-TRIAL; INFLIXIMAB; MAINTENANCE; RISK; IMMUNOSUPPRESSION; AZATHIOPRINE; PREDICTORS; REMISSION;

D O I：

10.1586/17474124.2015.1039989

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

Traditionally, patients with inflammatory bowel disease underwent step-up' therapy to induce a clinical remission. However, when step-up treatment is used, the more efficacious anti-TNF agents are reserved for patients unable to achieve remission with immune suppressants (IS). Several pivotal trials have demonstrated the superiority of early combination therapy of IS and anti-TNF to step-up' therapy and azathioprine or infliximab monotherapy. Concerns about treatment cost and adverse events of combination therapy have precluded widespread adoption of early combination therapy. Recent studies have demonstrated that combination treatment followed by withdrawal of IS or infliximab was not associated with an increased rate of relapse. Providers must include the benefits and risks of combination therapy in shared decision-making discussions with patients about to start treatment. Improved diagnostic and prognostic tests in the future are likely to help providers select the ideal patient for combination therapy.

引用

页码：715 / 717

页数：3

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