Document Detail

Managing the glucocorticoid dependent inflammatory bowel disease patient.
MedLine Citation:
PMID:  11726077     Owner:  NLM     Status:  MEDLINE    
At this time, standard therapy for treatment of inflammatory bowel disease includes the use of glucocorticoids for moderate to severe Crohn's disease, severe ulcerative colitis, and moderate ulcerative colitis failing mesalamine. Although the majority of patients will have clinical improvement with glucocorticoids, a substantial minority of patients will later flare with attempts to withdraw therapy. Given the numerous potential side effects associated with glucocorticoids, every effort should be made to switch these patients to a less toxic medication. Historically, the most reliable agents have been azathioprine or 6-mercaptopurine. Infliximab is a relatively new medication but would be expected to be beneficial for weaning glucocorticoids for Crohn's disease patients. Methotrexate is another alternative for Crohn's disease. Budesonide and CDP571 are still in developmental phases but likely will be helpful in managing this patient population. Mesalamine, cyclosporine, mycofenalate mofetil, and thalidomide have less data available to support their use but may be helpful for some patients. 6-Thioguanine may be an alternative to patients who do not tolerate 6-mercaptopurine or azathioprine.
G F Bonner
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Seminars in gastrointestinal disease     Volume:  12     ISSN:  1049-5118     ISO Abbreviation:  Semin. Gastrointest. Dis.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-11-29     Completed Date:  2002-03-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9100391     Medline TA:  Semin Gastrointest Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  IM    
Department of Gastroenterology, Cleveland Clinic Florida, Weston 33331, USA.
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MeSH Terms
6-Mercaptopurine / therapeutic use
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Antibodies, Monoclonal / therapeutic use
Antimetabolites / therapeutic use
Gastrointestinal Agents / therapeutic use
Glucocorticoids / adverse effects,  therapeutic use*
Inflammatory Bowel Diseases / drug therapy*
Middle Aged
Prednisone / adverse effects,  therapeutic use*
Sulfasalazine / therapeutic use
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Antibodies, Monoclonal; 0/Antimetabolites; 0/Gastrointestinal Agents; 0/Glucocorticoids; 0/infliximab; 50-44-2/6-Mercaptopurine; 53-03-2/Prednisone; 599-79-1/Sulfasalazine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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