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: Bruce E Sands
Format: Article
Language:English
Published: Wiley 2000-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2000/805015
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author Bruce E Sands
author_facet Bruce E Sands
author_sort Bruce E Sands
collection DOAJ
description 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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institution Kabale University
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spelling doaj-art-219003ba633c48309d4cd9cc5bbbfca62025-02-03T06:10:54ZengWileyCanadian Journal of Gastroenterology0835-79002000-01-0114Suppl C33C37C10.1155/2000/805015Medical Therapy of Steroid-Resistant Crohn's DiseaseBruce E Sands0Gastrointestinal Unit and Center for the Study of Inflammatory Bowel Disease, Massachusetts General Hospital, Boston, Massachusetts, USAGlucocorticosteroids 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.http://dx.doi.org/10.1155/2000/805015
spellingShingle Bruce E Sands
Medical Therapy of Steroid-Resistant Crohn's Disease
Canadian Journal of Gastroenterology
title Medical Therapy of Steroid-Resistant Crohn's Disease
title_full Medical Therapy of Steroid-Resistant Crohn's Disease
title_fullStr Medical Therapy of Steroid-Resistant Crohn's Disease
title_full_unstemmed Medical Therapy of Steroid-Resistant Crohn's Disease
title_short Medical Therapy of Steroid-Resistant Crohn's Disease
title_sort medical therapy of steroid resistant crohn s disease
url http://dx.doi.org/10.1155/2000/805015
work_keys_str_mv AT bruceesands medicaltherapyofsteroidresistantcrohnsdisease