Abstract
Crohn’s disease (CD) and ulcerative colitis (UC) are inflammatory conditions characterized by periods of symptomatic relapse and remission. The cause of inflammatory bowel disease (IBD) is unknown but it is believed to be caused by a combination of environmental, genetic, and immunological factors in which an uncontrolled immune response within the intestinal mucosa leads to inflammation in genetically predisposed individuals. Multifactorial evidence suggests that a defect of innate immune response to microbial agents, as well as abnormalities in adaptive immunity and epithelial barrier function are involved in IBD.1
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References
Torres MI, Rios A. Current view of the immunopathogenesis in inflammatory bowel disease and its implications for therapy. World J Gastroenterol. 2008;14(13):1972–80.
Summers RW, Switz DM, Sessions Jr JT, et al. National Cooperative Crohn’s Disease Study: results of drug treatment. Gastroenterology. 1979;77(4 Pt 2):847–69.
Malchow H, Ewe K, Brandes JW, et al. European Cooperative Crohn’s Disease Study (ECCDS): results of drug treatment. Gastroenterology. 1984;86(2):249–66.
Van Hees PA, Van Lier HJ, Van Elteren PH, et al. Effect of sulphasalazine in patients with active Crohn’s disease: a controlled double-blind study. Gut. 1981;22(5):404–9.
Anthonisen P, Barany F, Folkenborg O, et al. The clinical effect of salazosulphapyridine (Salazopyrin r) in Crohn’s disease. A controlled double-blind study. Scand J Gastroenterol. 1974;9(6):549–54.
Feagan BG. Aminosalicylates for active disease and in the maintenance of remission in Crohn’s disease. Eur J Surg. 1998;164(12):903–9.
Das KM, Eastwood MA, McManus JP, Sircus W. Adverse reactions during salicylazosulfapyridine therapy and the relation with drug metabolism and acetylator phenotype. N Engl J Med. 1973;289(10):491–5.
Sutherland L, Singleton J, Sessions J, et al. Double blind, placebo controlled trial of metronidazole in Crohn’s disease. Gut. 1991;32(9):1071–5.
Ursing B, Alm T, Barany F, et al. A comparative study of metronidazole and sulfasalazine for active Crohn’s disease: the cooperative Crohn’s disease study in Sweden. II. Result. Gastroenterology. 1982;83(3):550–62.
Greenbloom SL, Steinhart AH, Greenberg GR. Combination ciprofloxacin and metronidazole for active Crohn’s disease. Can J Gastroenterol. 1998;12(1):53–6.
Steinhart AH, Feagan BG, Wong CJ, et al. Combined budesonide and antibiotic therapy for active Crohn’s disease: a randomized controlled trial. Gastroenterology. 2002;123(1): 33–40.
Colombel JF, Lemann M, Cassagnou M, et al. A controlled trial comparing ciprofloxacin with mesalazine for the treatment of active Crohn’s disease. Groupe d’Etudes Therapeutiques des Affections Inflammatoires Digestives (GETAID). Am J Gastroenterol. 1999;94(3):674–8.
Prantera C, Zannoni F, Scribano ML, et al. An antibiotic regimen for the treatment of active Crohn’s disease: a randomized, controlled clinical trial of metronidazole plus ciprofloxacin. Am J Gastroenterol. 1996;91(2):328–32.
Shafran I, Johnson LK. An open-label evaluation of rifaximin in the treatment of active Crohn’s disease. Curr Med Res Opin. 2005;21(8):1165–9.
Otley A, Steinhart AH. Budesonide for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2005;4:CD000296.
Greenberg GR, Feagan BG, Martin F, et al. Oral budesonide for active Crohn’s disease. Canadian Inflammatory Bowel Disease Study Group. N Engl J Med. 1994;331(13):836–41.
Tremaine WJ, Hanauer SB, Katz S, et al. Budesonide CIR capsules (once or twice daily divided-dose) in active Crohn’s disease: a randomized placebo-controlled study in the United States. Am J Gastroenterol. 2002;97(7):1748–54.
Thomsen OO, Cortot A, Jewell D, et al. A comparison of budesonide and mesalamine for active Crohn’s disease. International Budesonide-Mesalamine Study Group. N Engl J Med. 1998;339(6):370–4.
Gross V, Andus T, Caesar I, et al. Oral pH-modified release budesonide versus 6-methylprednisolone in active Crohn’s disease. German/Austrian Budesonide Study Group. Eur J Gastroenterol Hepatol. 1996;8(9):905–9.
Rutgeerts P, Lofberg R, Malchow H, et al. A comparison of budesonide with prednisolone for active Crohn’s disease. N Engl J Med. 1994;331(13):842–5.
Bar-Meir S, Chowers Y, Lavy A, et al. Budesonide versus prednisone in the treatment of active Crohn’s disease. The Israeli Budesonide Study Group. Gastroenterology. 1998;115(4):835–40.
Campieri M, Ferguson A, Doe W, Persson T, Nilsson LG. Oral budesonide is as effective as oral prednisolone in active Crohn’s disease. The Global Budesonide Study Group. Gut. 1997;41(2):209–14.
Greenberg GR, Feagan BG, Martin F, et al. Oral budesonide as maintenance treatment for Crohn’s disease: a placebo-controlled, dose-ranging study. Canadian Inflammatory Bowel Disease Study Group. Gastroenterology. 1996;110(1):45–51.
Ferguson A, Campieri M, Doe W, Persson T, Nygard G. Oral budesonide as maintenance therapy in Crohn’s disease – results of a 12-month study. Global Budesonide Study Group. Aliment Pharmacol Ther. 1998;12(2):175–83.
Lofberg R, Rutgeerts P, Malchow H, et al. Budesonide prolongs time to relapse in ileal and ileocaecal Crohn’s disease. A placebo controlled one year study. Gut. 1996;39(1):82–6.
Hanauer S, Sandborn WJ, Persson A, Persson T. Budesonide as maintenance treatment in Crohn’s disease: a placebo-controlled trial. Aliment Pharmacol Ther. 2005;21(4):363–71.
Simms L, Steinhart AH. Budesonide for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev. 2001;1:CD002913.
Faubion Jr WA, Loftus Jr EV, Harmsen WS, Zinsmeister AR, Sandborn WJ. The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study. Gastroenterology. 2001;121(2):255–60.
Munkholm P, Langholz E, Davidsen M, Binder V. Frequency of glucocorticoid resistance and dependency in Crohn’s disease. Gut. 1994;35(3):360–2.
Franchimont DP, Louis E, Croes F, Belaiche J. Clinical pattern of corticosteroid dependent Crohn’s disease. Eur J Gastroenterol Hepatol. 1998;10(10):821–5.
Pearson DC, May GR, Fick GH, Sutherland LR. Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis. Ann Intern Med. 1995;123(2):132–42.
Candy S, Wright J, Gerber M, Adams G, Gerig M, Goodman R. A controlled double blind study of azathioprine in the management of Crohn’s disease. Gut. 1995;37(5):674–8.
Kandiel A, Fraser AG, Korelitz BI, Brensinger C, Lewis JD. Increased risk of lymphoma among inflammatory bowel disease patients treated with azathioprine and 6-mercaptopurine. Gut. 2005;54(8):1121–5.
Beaugerie L, Brousse N, Bouvier AM, et al. Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study. Lancet. 2009;374(9701):1617–25.
Aberra FN, Lichtenstein GR. Review article: monitoring of immunomodulators in inflammatory bowel disease. Aliment Pharmacol Ther. 2005;21(4):307–19.
Hayee BH, Harris AW. Methotrexate for Crohn’s disease: experience in a district general hospital. Eur J Gastroenterol Hepatol. 2005;17(9):893–8.
Alfadhli AA, McDonald JW, Feagan BG. Methotrexate for induction of remission in refractory Crohn’s disease. Cochrane Database Syst Rev. 2005;1:CD003459.
Feagan BG, Rochon J, Fedorak RN, et al. Methotrexate for the treatment of Crohn’s disease. The North American Crohn’s Study Group Investigators. N Engl J Med. 1995;332(5):292–7.
Chong RY, Hanauer SB, Cohen RD. Efficacy of parenteral methotrexate in refractory Crohn’s disease. Aliment Pharmacol Ther. 2001;15(1):35–44.
Lemann M, Chamiot-Prieur C, Mesnard B, et al. Methotrexate for the treatment of refractory Crohn’s disease. Aliment Pharmacol Ther. 1996;10(3):309–14.
Lemann M, Zenjari T, Bouhnik Y, et al. Methotrexate in Crohn’s disease: long-term efficacy and toxicity. Am J Gastroenterol. 2000;95(7):1730–4.
Feagan BG, Fedorak RN, Irvine EJ, et al. A comparison of methotrexate with placebo for the maintenance of remission in Crohn’s disease. North American Crohn’s Study Group Investigators. N Engl J Med. 2000;342(22):1627–32.
Targan SR, Hanauer SB, van Deventer SJ, et al. A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn’s disease. Crohn’s Disease cA2 Study Group. N Engl J Med. 1997;337(15):1029–35.
Hanauer SB, Feagan BG, Lichtenstein GR, et al. Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet. 2002;359(9317):1541–9.
Present DH, Rutgeerts P, Targan S, et al. Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med. 1999;340(18):1398–405.
Lichtenstein GR, Yan S, Bala M, Blank M, Sands BE. Infliximab maintenance treatment reduces hospitalizations, surgeries, and procedures in fistulizing Crohn’s disease. Gastroenterology. 2005;128(4):862–9.
Generini S, Giacomelli R, Fedi R, et al. Infliximab in spondyloarthropathy associated with Crohn’s disease: an open study on the efficacy of inducing and maintaining remission of musculoskeletal and gut manifestations. Ann Rheum Dis. 2004;63(12):1664–9.
Brooklyn TN, Dunnill MG, Shetty A, et al. Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut. 2006;55(4):505–9.
Herfarth H, Obermeier F, Andus T, et al. Improvement of arthritis and arthralgia after treatment with infliximab (Remicade) in a German prospective, open-label, multicenter trial in refractory Crohn’s disease. Am J Gastroenterol. 2002;97(10): 2688–90.
Sands BE, Anderson FH, Bernstein CN, et al. Infliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med. 2004;350(9):876–85.
Colombel JF, Sandborn WJ, Rutgeerts P, et al. Adalimumab for maintenance of clinical response and remission in patients with Crohn’s disease: the CHARM trial. Gastroenterology. 2007;132(1):52–65.
Rutgeerts P, Van Assche G, Vermeire S. Review article: Infliximab therapy for inflammatory bowel disease – seven years on. Aliment Pharmacol Ther. 2006;23(4):451–63.
Schroder O, Blumenstein I, Stein J. Combining infliximab with methotrexate for the induction and maintenance of remission in refractory Crohn’s disease: a controlled pilot study. Eur J Gastroenterol Hepatol. 2006;18(1):11–6.
Sandborn WJ, Feagan BG, Stoinov S, et al. Certolizumab pegol for the treatment of Crohn’s disease. N Engl J Med. 2007;357(3):228–38.
Rutgeerts PJ, Mellili LE, Li J, Pollack PF. Adalimumab maintains improvement in IBDQ scores over 1 year following the initial attainment of remission in patients with moderately severely active Crohn’s disease: results of the Classic II study. Gastroenterology. 2006;130:A479.
Sandborn WJ, Hanauer S, Loftus Jr EV, et al. An open-label study of the human anti-TNF monoclonal antibody adalimumab in subjects with prior loss of response or intolerance to infliximab for Crohn’s disease. Am J Gastroenterol. 2004;99(10):1984–9.
Papadakis KA, Shaye OA, Vasiliauskas EA, et al. Safety and efficacy of adalimumab (D2E7) in Crohn’s disease patients with an attenuated response to infliximab. Am J Gastroenterol. 2005;100(1):75–9.
Hanauer SB, Sandborn WJ, Rutgeerts P, et al. Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn’s disease: the CLASSIC-I trial. Gastroenterology. 2006;130(2):323–33. quiz 591.
Sandborn W, Rutgeerts P, Enns RA, Hanauer SB, Colombel JF, Panaccione R, et al. Adalimumab rapidly induces clinical remission and response in patients with moderate to severe Crohn’s disease who had secondary failure to infliximab therapy: results of the GAIN study. Am J Gastroenterol. 2006;101(Abstract):S448.
Schreiber S, Rutgeerts P, Fedorak RN, et al. A randomized, placebo-controlled trial of certolizumab pegol (CDP870) for treatment of Crohn’s disease. Gastroenterology. 2005;129(3): 807–18.
Schreiber S, Khaliq-Kareemi M, Lawrence I, Hanauer SB, McColm J, Bloomfield R, et al. Certolizumab pegol, a humanized anti-TNF pegylated FAb fragment is safe and effective in the maintenance of response and remission following induction in active Crohn’s disease: a phase III study (PRECiSE II). Gut. 2005;54(Abstract):A82.
Winter TA, Wright J, Ghosh S, Jahnsen J, Innes A, Round P. Intravenous CDP870, a PEGylated Fab′ fragment of a humanized antitumour necrosis factor antibody, in patients with moderate-to-severe Crohn’s disease: an exploratory study. Aliment Pharmacol Ther. 2004;20(11–12):1337–46.
Sandborn W, Feagan BG, Stoinov S, Honiball PJ, Rutgeerts P, McColm JA, et al. Certolizumab pegol administered subcutaneously is effective and well tolerated in patients with active Crohn’s disease: results from a 26 week, placebo controlled phase II study (PRECiSE 1). Gastroenterology. 2006;130(Abstract):A107.
Rutgeerts P, D’Haens GR, Van Assche GA, et al. Adalimumab induces and maintains mucosal healing in patients with moderate to severe ileocolonic Crohn’s disease – first results of the EXTEND trial. Program and abstracts from Digestive Disease Week, 30 May–4 June 2009, Chicago, IL. Abstract 751e.
Colombel JF, Schwartz DA, Sandborn WJ, et al. Adalimumab for the treatment of fistulas in patients with Crohn’s disease. Gut. 2009;58(7):940–8.
Lofberg R, Louis E, Reinisch W, et al. Adalimumab induces sustained fistula healing in both anti-TNF-Naïve and anti-TNF-experienced patients with Crohn’s disease: The Care Trial. Program and abstracts from Digestive Disease Week, 30 May–4 June 2009, Chicago, IL. Abstract S1144.
Schreiber S, Khaliq-Kareemi M, Lawrance IC, et al. Maintenance therapy with certolizumab pegol for Crohn’s disease. N Engl J Med. 2007;357(3):239–50.
D’Haens G, Baert F, van Assche G, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn’s disease: an open randomised trial. Lancet. 2008;371(9613):660–7.
Sandborn W, Rutgeerts P, Reinisch W, et al. SONIC: A randomized double-blind, controlled trial comparing infliximab and infliximab and azathioprine to azathioprine in patients with Crohn’s disease naive to immunomodulators and biologic therapy. Am J Gastroenterol. 2008;103:1117. Abstract 29.
Schreiber S, Reinisch W, Colombel JF, Sandborn WJ, Hommes DW, Li J, et al. Early Crohn’s disease shows high levels of remission to therapy with adalimumab: sub-analysis of Charm. Gastroenterology. 2007;132(4 Suppl 2):A-147.
Panaccione RCJ, Enns R, Feagan B, Hanauer S, Lawrence I, Rutgeerts P, et al. Natalizumab maintains remission in patients with moderately to severely active Crohn’s disease for up to 2 years: results from an open-label extension study. Gastroenterology. 2006;130(Abstract):A111.
Ghosh S, Goldin E, Gordon FH, et al. Natalizumab for active Crohn’s disease. N Engl J Med. 2003;348(1):24–32.
Sandborn WJ, Colombel JF, Enns R, et al. Natalizumab induction and maintenance therapy for Crohn’s disease. N Engl J Med. 2005;353(18):1912–25.
Targan S, Feagan B, Fedorak R, Lashner B, Panacionne R, Present D, et al. Natalizumab induces sustained response and remission in patients with active Crohn’s disease: results from the ENCORE trial. Gastroenterology. 2006;130(Abstract):A108.
Baert F, Noman M, Vermeire S, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn’s disease. N Engl J Med. 2003;348(7):601–8.
Afif W, Loftus EV Jr, Faubion W et al. Clinical utility of measuring infliximab and human anti-chimeric antibody concentrations in patients with inflammatory bowel disease. Am J Gastroenterol. 2010;105(5):1133–9.
Sandborn WJ, Rutgeerts P, Enns R, et al. Adalimumab induction therapy for Crohn disease previously treated with infliximab: a randomized trial. Ann Intern Med. 2007;146(12):829–38.
Hanauer SB, Wagner CL, Bala M, et al. Incidence and importance of antibody responses to infliximab after maintenance or episodic treatment in Crohn’s disease. Clin Gastroenterol Hepatol. 2004;2(7):542–53.
FDA Consumer Resources Page. Food and Drug Administration Web site. http://www.fda.gov/Forconsumers/ConsumersUpdates/ucm107878.htm (2008). Accessed 12 Nov 2009.
Clark M, Colombel JF, Feagan BC, et al. American gastroenterological association consensus development conference on the use of biologics in the treatment of inflammatory bowel disease, June 21–23, 2006. Gastroenterology. 2007;133(1):312–39.
Siegel CA, Marden SM, Persing SM, Larson RJ, Sands BE. Risk of lymphoma associated with combination anti-tumor necrosis factor and immunomodulator therapy for the treatment of Crohn’s disease: a meta-analysis. Clin Gastroenterol Hepatol. 2009;7(8):874–81.
Yousry TA, Major EO, Ryschkewitsch C, et al. Evaluation of patients treated with natalizumab for progressive multifocal leukoencephalopathy. N Engl J Med. 2006;354(9):924–33.
FDA Drug Safety Page. Food and Drug Administration Web site. http://www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/ucm120064.htm (2008). Accessed 15 Nov 2009.
van Dieren JM, Kuipers EJ, Samsom JN, Nieuwenhuis EE, van der Woude CJ. Revisiting the immunomodulators tacrolimus, methotrexate, and mycophenolate mofetil: their mechanisms of action and role in the treatment of IBD. Inflamm Bowel Dis. 2006;12(4):311–27.
Baumgart DC, Wiedenmann B, Dignass AU. Rescue therapy with tacrolimus is effective in patients with severe and refractory inflammatory bowel disease. Aliment Pharmacol Ther. 2003;17(10):1273–81.
Ierardi E, Principi M, Francavilla R, et al. Oral tacrolimus long-term therapy in patients with Crohn’s disease and steroid resistance. Aliment Pharmacol Ther. 2001;15(3):371–7.
Lowry PW, Weaver AL, Tremaine WJ, Sandborn WJ. Combination therapy with oral tacrolimus (FK506) and azathioprine or 6-mercaptopurine for treatment-refractory Crohn’s disease perianal fistulae. Inflamm Bowel Dis. 1999;5(4):239–45.
Sandborn WJ, Present DH, Isaacs KL, et al. Tacrolimus for the treatment of fistulas in patients with Crohn’s disease: a randomized, placebo-controlled trial. Gastroenterology. 2003;125(2):380–8.
de Oca J, Vilar L, Castellote J, et al. Immunodulation with tacrolimus (FK506): results of a prospective, open-label, non-controlled trial in patients with inflammatory bowel disease. Rev Esp Enferm Dig. 2003;95(7):465–70. 459–64.
Casson DH, Eltumi M, Tomlin S, Walker-Smith JA, Murch SH. Topical tacrolimus may be effective in the treatment of oral and perineal Crohn’s disease. Gut. 2000;47(3):436–40.
Lukas M. What is the time for surgery in severe Crohn’s disease? Inflamm Bowel Dis. 2008;14:S271–2.
Akobeng AK, Gardener E. Oral 5-aminosalicylic acid for maintenance of medically-induced remission in Crohn’s disease. Cochrane Database Syst Rev. 2005;(1):CD003715.
Modigliani R, Colombel JF, Dupas JL, et al. Mesalamine in Crohn’s disease with steroid-induced remission: effect on steroid withdrawal and remission maintenance, Groupe d’Etudes Therapeutiques des Affections Inflammatoires Digestives. Gastroenterology. 1996;110(3):688–93.
Blum E, Katz JA. Postoperative therapy for Crohn’s disease. Inflamm Bowel Dis. 2009;15(3):463–72.
Achkar JP, Hanauer SB. Medical therapy to reduce postoperative Crohn’s disease recurrence. Am J Gastroenterol. 2000;95(5):1139–46.
Camma C, Giunta M, Rosselli M, Cottone M. Mesalamine in the maintenance treatment of Crohn’s disease: a meta-analysis adjusted for confounding variables. Gastroenterology. 1997;113(5):1465–73.
Lochs H, Mayer M, Fleig WE, et al. Prophylaxis of postoperative relapse in Crohn’s disease with mesalamine: European Cooperative Crohn’s Disease Study VI. Gastroenterology. 2000;118(2):264–73.
Hanauer SB, Korelitz BI, Rutgeerts P, et al. Postoperative maintenance of Crohn’s disease remission with 6-mercaptopurine, mesalamine, or placebo: a 2-year trial. Gastroenterology. 2004;127(3):723–9.
Ardizzone S, Maconi G, Russo A, Imbesi V, Colombo E, Bianchi Porro G. Randomised controlled trial of azathioprine and 5-aminosalicylic acid for treatment of steroid dependent ulcerative colitis. Gut. 2006;55(1):47–53.
Ardizzone S, Maconi G, Sampietro GM, et al. Azathioprine and mesalamine for prevention of relapse after conservative surgery for Crohn’s disease. Gastroenterology. 2004;127(3):730–40.
Sorrentino D, Terrosu G, Avellini C, Beltrami CA, Bresadola V, Toso F. Prevention of postoperative recurrence of Crohn’s disease by infliximab. Eur J Gastroenterol Hepatol. 2006;18(4):457–9.
Regueiro M, Schraut W, Baidoo L, et al. Infliximab prevents Crohn’s disease recurrence after ileal resection. Gastroenterology. 2009;136(2):441–50.e1. quiz 716.
Rutgeerts P, Hiele M, Geboes K, et al. Controlled trial of metronidazole treatment for prevention of Crohn’s recurrence after ileal resection. Gastroenterology. 1995;108(6):1617–21.
Schwartz DA, Pemberton JH, Sandborn WJ. Diagnosis and treatment of perianal fistulas in Crohn disease. Ann Intern Med. 2001;135(10):906–18.
Bernstein LH, Frank MS, Brandt LJ, Boley SJ. Healing of perineal Crohn’s disease with metronidazole. Gastroenterology. 1980;79(2):357–65.
Brandt LJ, Bernstein LH, Boley SJ, Frank MS. Metronidazole therapy for perineal Crohn’s disease: a follow-up study. Gastroenterology. 1982;83(2):383–7.
Jakobovits J, Schuster MM. Metronidazole therapy for Crohn’s disease and associated fistulae. Am J Gastroenterol. 1984;79(7):533–40.
Mahadevan U, Marion JF, Present DH. Fistula response to methotrexate in Crohn’s disease: a case series. Aliment Pharmacol Ther. 2003;18(10):1003–8.
Gionchetti P, Rizzello F, Venturi A, et al. Comparison of oral with rectal mesalazine in the treatment of ulcerative proctitis. Dis Colon Rectum. 1998;41(1):93–7.
Cohen RD, Woseth DM, Thisted RA, Hanauer SB. A meta-analysis and overview of the literature on treatment options for left-sided ulcerative colitis and ulcerative proctitis. Am J Gastroenterol. 2000;95(5):1263–76.
Mulder CJ, Fockens P, Meijer JW, van der Heide H, Wiltink EH, Tytgat GN. Beclomethasone dipropionate (3 mg) versus 5-aminosalicylic acid (2 g) versus the combination of both (3 mg/2 g) as retention enemas in active ulcerative proctitis. Eur J Gastroenterol Hepatol. 1996;8(6):549–53.
Safdi M, DeMicco M, Sninsky C, et al. A double-blind comparison of oral versus rectal mesalamine versus combination therapy in the treatment of distal ulcerative colitis. Am J Gastroenterol. 1997;92(10):1867–71.
Lee FI, Jewell DP, Mani V, et al. A randomised trial comparing mesalazine and prednisolone foam enemas in patients with acute distal ulcerative colitis. Gut. 1996;38(2):229–33.
Nielsen OH. Sulfasalazine intolerance. A retrospective survey of the reasons for discontinuing treatment with sulfasalazine in patients with chronic inflammatory bowel disease. Scand J Gastroenterol. 1982;17(3):389–93.
Sutherland L, Macdonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. 2006;(2):CD000543.
Marteau P, Probert CS, Lindgren S, et al. Combined oral and enema treatment with Pentasa (mesalazine) is superior to oral therapy alone in patients with extensive mild/moderate active ulcerative colitis: a randomised, double blind, placebo controlled study. Gut. 2005;54(7):960–5.
Sands BE. Fulminant colitis. J Gastrointest Surg. 2008;12(12): 2157–9.
George J, Present DH, Pou R, Bodian C, Rubin PH. The long-term outcome of ulcerative colitis treated with 6-mercaptopurine. Am J Gastroenterol. 1996;91(9):1711–4.
Adler DJ, Korelitz BI. The therapeutic efficacy of 6-mercaptopurine in refractory ulcerative colitis. Am J Gastroenterol. 1990;85(6):717–22.
Fraser AG, Orchard TR, Jewell DP. The efficacy of azathioprine for the treatment of inflammatory bowel disease: a 30 year review. Gut. 2002;50(4):485–9.
Naftali T, Novis B, Pomeranz I, et al. Cyclosporine for severe ulcerative colitis. Isr Med Assoc J. 2000;2(8):588–91.
Lichtiger S, Present DH, Kornbluth A, et al. Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N Engl J Med. 1994;330(26):1841–5.
Svavoni F, Bonassi U, Bonassi F. Effectiveness of cyclosporine in the treatment of refractory ulcerative colitis. Gastroenterology. 1998;114:A1096.
Hogenauer C, Wenzl HH, Hinterleitner TA, Petritsch W. Effect of oral tacrolimus (FK 506) on steroid-refractory moderate/severe ulcerative colitis. Aliment Pharmacol Ther. 2003;18(4):415–23.
Ogata H, Matsui T, Nakamura M, et al. A randomised dose finding study of oral tacrolimus (FK506) therapy in refractory ulcerative colitis. Gut. 2006;55(9):1255–62.
Rutgeerts P, Sandborn WJ, Feagan BG, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2005;353(23):2462–76.
Sandborn WJ, Rutgeerts P, Feagan BG, et al. Colectomy rate comparison after treatment of ulcerative colitis with placebo or infliximab. Gastroenterology. 2009;137(4):1250–60. quiz 1520.
Hanauer S, Good LI, Goodman MW, et al. Long-term use of mesalamine (Rowasa) suppositories in remission maintenance of ulcerative proctitis. Am J Gastroenterol. 2000;95(7):1749–54.
Mantzaris GJ, Hatzis A, Petraki K, Spiliadi C, Triantaphyllou G. Intermittent therapy with high-dose 5-aminosalicylic acid enemas maintains remission in ulcerative proctitis and proctosigmoiditis. Dis Colon Rectum. 1994;37(1):58–62.
Dignass A, Veerman H. Once versus twice daily mesalazine (Pentasa) for the maintenance of remission in ulcerative colitis: the result from a multinational study. Gut. 2008;57 Suppl 1:A1.
Kruis W, Gorelov A, Kiudelis G. Once daily dosing of 3g mesalamine is therapeutic equivalent to a three times daily dosing of 1g mesalamine for the treatment of active ulcerative colitis. Gastroenterology. 2007;132:A130.
Ardizzone S, Molteni P, Imbesi V, Bollani S, Bianchi Porro G. Azathioprine in steroid-resistant and steroid-dependent ulcerative colitis. J Clin Gastroenterol. 1997;25(1):330–3.
Timmer A, McDonald JW, Macdonald JK. Azathioprine and 6-mercaptopurine for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2007;(1):CD000478.
Sutherland L, MacDonald JK. Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. 2003;(3):CD000543.
Hawthorne AB, Logan RF, Hawkey CJ, et al. Randomised controlled trial of azathioprine withdrawal in ulcerative colitis. BMJ. 1992;305(6844):20–2.
Aberra FN, Lewis JD, Hass D, Rombeau JL, Osborne B, Lichtenstein GR. Corticosteroids and immunomodulators: postoperative infectious complication risk in inflammatory bowel disease patients. Gastroenterology. 2003;125(2):320–7.
Mahadevan U, Loftus Jr EV, Tremaine WJ, et al. Azathioprine or 6-mercaptopurine before colectomy for ulcerative colitis is not associated with increased postoperative complications. Inflamm Bowel Dis. 2002;8(5):311–6.
Reding R, Michel LA, Donckier J, de Canniere L, Jamart J. Surgery in patients on long-term steroid therapy: a tentative model for risk assessment. Br J Surg. 1990;77(10):1175–8.
Stein RB, Hanauer SB. Comparative tolerability of treatments for inflammatory bowel disease. Drug Saf. 2000;23(5):429–48.
Subramanian V, Saxena S, Kang JY, Pollok RC. Preoperative steroid use and risk of postoperative complications in patients with inflammatory bowel disease undergoing abdominal surgery. Am J Gastroenterol. 2008;103(9):2373–81.
Stuck AE, Minder CE, Frey FJ. Risk of infectious complications in patients taking glucocorticosteroids. Rev Infect Dis. 1989;11(6):954–63.
Colombel JF, Loftus Jr EV, Tremaine WJ, et al. Early postoperative complications are not increased in patients with Crohn’s disease treated perioperatively with infliximab or immunosuppressive therapy. Am J Gastroenterol. 2004;99(5):878–83.
Kunitake H, Hodin R, Shellito PC, Sands BE, Korzenik J, Bordeianou L. Perioperative treatment with infliximab in patients with Crohn’s disease and ulcerative colitis is not associated with an increased rate of postoperative complications. J Gastrointest Surg. 2008;12(10):1730–6. discussion 1736–7.
Appau KA, Fazio VW, Shen B, et al. Use of infliximab within 3 months of ileocolonic resection is associated with adverse postoperative outcomes in Crohn’s patients. J Gastrointest Surg. 2008;12(10):1738–44.
Selvasekar CR, Cima RR, Larson DW, et al. Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis. J Am Coll Surg. 2007;204(5):956–62. discussion 962–3.
Madden MV, McIntyre AS, Nicholls RJ. Double-blind crossover trial of metronidazole versus placebo in chronic unremitting pouchitis. Dig Dis Sci. 1994;39(6):1193–6.
Maser EA, Present DH. Pouch-ouch. Curr Opin Gastroenterol. 2008;24(1):70–4.
Gionchetti P, Rizzello F, Venturi A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology. 2000;119(2):305–9.
Gionchetti P, Rizzello F, Venturi A, et al. Antibiotic combination therapy in patients with chronic, treatment-resistant pouchitis. Aliment Pharmacol Ther. 1999;13(6):713–8.
Isaacs KL, Sandler RS, Abreu M, et al. Rifaximin for the treatment of active pouchitis: a randomized, double-blind, placebo-controlled pilot study. Inflamm Bowel Dis. 2007;13(10):1250–5.
Baidoo L, Kundu R, Su C. Rifaximin is an effective antibiotic for the treatment of pouchitis. Gastroenterology. 2005;128:A797.
Gionchetti P, Rizzello F, Poggioli G, et al. Oral budesonide in the treatment of chronic refractory pouchitis. Aliment Pharmacol Ther. 2007;25(10):1231–6.
Gionchetti P, Morselli C, Rizzello F, et al. Infliximab in the treatment of refractory pouchitis. Gastroenterology. 2005; 128:A578.
Gionchetti P, Rizzello F, Helwig U, et al. Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. Gastroenterology. 2003;124(5):1202–9.
Colombel JF, Ricart E, Loftus Jr EV, et al. Management of Crohn’s disease of the ileoanal pouch with infliximab. Am J Gastroenterol. 2003;98(10):2239–44.
Shen B, Remzi FH, Shen L. Efficacy and safety of adalimumab in the treatment of Crohn’s disease of the ileal pouch. The annual meeting of the American College of Gastroenterology, Orlando, FL; 2008. Abstract:620.
Acknowledgments.
This chapter was written by Stephen B. Hanauer, Wee-Chian Lim, and Miles Sparrow in the previous version of this textbook. The author wishes to thank Stacey Grabert, Pharm.D., MS, for editorial assistance in preparing this manuscript.
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Sands, B.E. (2011). IBD: Medical Management. In: Beck, D.E., Roberts, P.L., Saclarides, T.J., Senagore, A.J., Stamos, M.J., Wexner, S.D. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1584-9_28
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