New Therapies

  • Maria Lia Scribano
  • Maria Laura Annunziata
Part of the Updates in Surgery book series (UPDATESSURG)


The advent of biological therapies over the past decade has initiated a new therapeutic era for the treatment of Crohn’s disease (CD), especially for patients with corticosteroid-dependent, corticosteroid-refractory or fistulizing disease. For years the primary goal of traditional therapies has been the control of disease-related symptoms. However, emerging evidence from inflammatory bowel disease (IBD) research suggests that the new biological agents not only control symptoms but may also alter the natural history of the disease. Accordingly, the therapeutic goals in the medical treatment of CD are changing and now include the rapid induction of clinical remission, the maintenance of steroid-free clinical remission, the healing of mucosal lesions, improvements in health-related quality of life, and a reduction in both the need for surgery and hospital stay.


Progressive Multifocal Leukoencephalopathy Progressive Multifocal Leukoencephalopathy Episodic Treatment Certolizumab Pegol Charm Trial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hanauer SB, Feagan BC, Lichtenstein GR et al (2002) Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet 359:1541–1549CrossRefPubMedGoogle Scholar
  2. 2.
    Rutgeerts P, Feagan BG, Lichtenstein GR et al (2004) Comparison of scheduled and episodic treatment strategies of infliximab in Crohn’s disease. Gastroenterology 126; 402–413CrossRefPubMedGoogle Scholar
  3. 3.
    Rutgeerts P, Diamond RH, Bala M et al (2006) Scheduled maintenance treatment with infliximab is superior to episodic treatment for the healing of mucosal ulceration associated with Crohn’s disease. Gastrointest Endosc 63:433–442CrossRefPubMedGoogle Scholar
  4. 4.
    Gisbert JP, Panes J (2009) Loss of response and requirement of infliximab dose intensification in Crohn’s disease: a review. Am J Gastroenterol 104:760–767CrossRefPubMedGoogle Scholar
  5. 5.
    Lemann M, Mary JY, Duclos B et al (2006) Infliximab plus azathioprine for steroid-dependent Crohn’s disease patients: a randomized, placebo-controlled trial. Gastroenterology 130:1054–1061CrossRefPubMedGoogle Scholar
  6. 6.
    Sanborn W, Rutgeerts P, Reinisch et al (2008) SONIC: a randomized, double-blind, controlled trial comparing infliximab and infliximab plus azathioprine to azathioprine in patients with Crohn’s disease naïve to immunomodulators and biologic therapy. Am J Gastroenterol 103:1117 (Abstract)Google Scholar
  7. 7.
    Schroder O, Blumenstein I, Stein J et al (2006) Combining infliximab with methotrexate for the induction and maintenance of remission in refractory Crohn’s disease: a controlled pilot study. Eur J Gastroenterol Hepatol 18:11–16CrossRefPubMedGoogle Scholar
  8. 8.
    Present DH, Rutgeerts P, Targan S et al (1999) Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med 340:1398–1405CrossRefPubMedGoogle Scholar
  9. 9.
    Sands BE, Anderson FH, Bernstein CN et al (2004) Infliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med 350:876–885CrossRefPubMedGoogle Scholar
  10. 10.
    Hanauer SB, Sandborn WJ, Rutgeerts P et al (2006) Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn’s disease: the CLASSIC-I trial. Gastroenterology 130:323–333CrossRefPubMedGoogle Scholar
  11. 11.
    Sandborn WJ, Hanauer SB, Rutgeerts P et al (2007) Adalimumab for maintenance treatment of Crohn’s disease: results of the CLASSIC-II trial. Gut 56:1232–1239CrossRefPubMedGoogle Scholar
  12. 12.
    Colombel JF, Sanborn WJ, Rutgeerts P et al (2007) Adalimumab for maintenance of clinical response and remission in patients with Crohn’s disease: the CHARM trial. Gastroenterology 132:52–65CrossRefPubMedGoogle Scholar
  13. 13.
    Sandborn WJ, Rutgeerts P, Enns R et al (2007) Adalimumab induction therapy for Crohn’s disease previously treated with infliximab. Ann Intern Med 146:829–838PubMedGoogle Scholar
  14. 14.
    Sandborn WJ, Feagan BG, Stoinov S et al (2007) Certolizumab pegol for the treatment of Crohn’s disease. N Engl J Med 357:228–238CrossRefPubMedGoogle Scholar
  15. 15.
    Schreiber S, Khaliq-Kareemi M, Lawrence IC et al (2007) Maintenance therapy with certolizumab pegol for Crohn’s disease. N Engl J Med 357:239–250CrossRefPubMedGoogle Scholar
  16. 16.
    Vermeire S, Abreu MT, D’Haens G et al (2008) Efficacy and safety of certolizumab pegol in patients with active Crohn’s disease who previously lost response or were intolerant to infliximab: open-label induction preliminary results of the Welcome study. Gastroenterology 134:A67CrossRefGoogle Scholar
  17. 17.
    Lichtenstein GR, Feagan BG, Cohen RD et al (2006) Serious infections and mortality in association with therapies for Crohn’s disease: TREAT registry. Clin Gastroenterol Hepatol 4:621–630CrossRefPubMedGoogle Scholar
  18. 18.
    Biancone L, Orlando A, Kohn A et al (2006) Infliximab and newly diagnosed neoplasia in Crohn’s disease: a multicentre, pair study. Gut 55:228–233CrossRefPubMedGoogle Scholar
  19. 19.
    Mackey AC, Green L, Liang LC et al (2007) Hepatosplenic T cell lymphoma associated with infliximab use in young patients treated for inflammatory bowel disease. J Pediatr Gastroenterol Nutr 44:265–267CrossRefPubMedGoogle Scholar
  20. 20.
    Gordon FH, Lai CW, Hamilton MI et al (2001) A randomized placebo-controlled trial of a humanized monoclonal antibody to alpha4 integrin in active Crohn’s disease. Gastroenterology 121:268–274CrossRefPubMedGoogle Scholar
  21. 21.
    Ghosh S, Goldin E, Gordon FH et al (2003) Natalizumab for active Crohn’s disease. N Engl J Med 348:24–32CrossRefPubMedGoogle Scholar
  22. 22.
    Sandborn WJ, Colombel JF, Enns R et al (2005) Natalizumab induction and maintenance therapy for Crohn’s disease. N Engl J Med 353:1912–1925CrossRefPubMedGoogle Scholar
  23. 23.
    Targan SR, Feagan BG, Fedorak RN et al (2007) Natalizumab for the treatment of active Crohn’s disease: results of the ENCORE trial. Gastroenterology 132:1672–1683CrossRefPubMedGoogle Scholar
  24. 24.
    Macdonald JK, McDonald JW (2006) Natalizumab for induction of remission in Crohn’s disease. Cochrane Database Syst Rev (3): CD006097PubMedGoogle Scholar
  25. 25.
    Van Assche G, Van Ranst M, Sciot R et al (2005) Progressive multifocal leukoencephalopathy after natalizumab therapy for Crohn’s disease. N Engl J Med 353:362–368CrossRefPubMedGoogle Scholar
  26. 26.
    Yousry TA, Major EO, Ryschkewitsch C et al (2006) Evaluation of patients treated with natalizumab for progressive multifocal leukoencephalopathy. N Engl J Med 354:924–933CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2010

Authors and Affiliations

  • Maria Lia Scribano
    • 1
  • Maria Laura Annunziata
    • 1
  1. 1.Gastroenterology UnitSan Camillo-Forlanini HospitalRomeItaly

Personalised recommendations