Medical Therapy of Steroid-Resistant Crohn's Disease
Glucocorticosteroids are commonly used in the treatment of moderate to severe Crohn’s disease and are effective for the short term amelioration of symptoms. However, not all patients respond to corticosteroid therapy. Approximately 20% of patients fail to respond to initial treatment with steroids,...
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| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2000-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2000/805015 |
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| Summary: | Glucocorticosteroids
are commonly used in the treatment of moderate to severe
Crohn’s disease and are effective for the short term
amelioration of symptoms. However, not all patients respond to
corticosteroid therapy. Approximately 20% of patients fail to respond
to initial treatment with steroids, while 36% of patients
may be considered steroid dependent. Sharp distinctions between
steroid-dependent and steroid-resistant populations are
difficult to draw because steroid responsiveness is often dose dependent.
Clearer distinctions may be drawn between those who
fail to respond to initial treatment with corticosteroids and those
who have secondary failure later in the course of their disease on
repeated treatment. Effective therapies for steroid-resistant
Crohn’s disease include azathioprine and 6-mercaptopurine,
methotrexate, cyclosporine and infliximab. Limited data are
available on the use of tacrolimus, mycophenolate mofetil and
thalidomide. Steroid-resistant Crohn’s disease, while involving a
small minority of patients, continues to present a difficult therapeutic
challenge. |
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| ISSN: | 0835-7900 |