摘要
背景:克罗恩病(CD)是一种慢性,致残和破坏性疾病。一半患者会发生肠道损伤(狭窄,瘘管和/或脓肿)。目前的治疗策略未能改变其自然史。 目标:我们在一篇综述文章中探讨了从治疗强化的线性序列到集中于个性化患者护理的复杂算法超过四分之一个世纪的CD治疗的演变。具体而言,我们将重点放在评估疾病严重程度,选择严格的治疗目标,开始有效的治疗疗法以及管理继发性应答损失等不断发展的概念上。 结果:严格监测炎症的客观体征和治疗至靶向的方法可能是改变患者生命和疾病过程的唯一方法。我们现在试图根据患者概况,疾病表型和随后发生的独特药效动力学优化我们的治疗工具。 结论:用最新的治疗算法标准化胃肠专科医生的临床实践可能会最大限度地减少疾病相关并发症,同时有利于患者的生活质量。
关键词: 克罗恩病,治疗目标,抗肿瘤,治疗算法,药物监测,粘膜愈合。
图形摘要
Current Drug Targets
Title:Evolving Treatment Algorithms in Crohn's Disease
Volume: 19 Issue: 7
关键词: 克罗恩病,治疗目标,抗肿瘤,治疗算法,药物监测,粘膜愈合。
摘要: Background: Crohn's disease (CD) is a chronic, disabling and destructive condition. Half of patients will develop some bowel damage (stricture, fistula and/or abscess). Current therapeutic strategies failed to alter its natural history.
Objective: We explore in a review article the evolution of CD treatment over a quarter of a century from a linear sequence of treatment intensification to a complex algorithm focused on individualized patient care by looking beyond symptoms. Specifically we focus on evolving concepts in assessing disease severity, selecting rigorous treatment end-targets, initiating an effective therapeutic therapy, and managing secondary loss of response.
Results: A tight monitoring of objective signs of inflammation and a treat-to-target approach are probably the only way to change patients' life and disease course. We now seek to optimize our therapeutic tools according to patient profile, disease phenotype and the unique pharmacodynamics that ensues.
Conclusion: Standardizing the clinical practice of gastroenteroogists with the most current treatment algorithm may minimize disease related complications while favouring patient’s quality of life.
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Cite this article as:
Evolving Treatment Algorithms in Crohn's Disease, Current Drug Targets 2018; 19 (7) . https://dx.doi.org/10.2174/1389450117666160607075557
DOI https://dx.doi.org/10.2174/1389450117666160607075557 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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