Document Detail


Is there a therapeutic window of opportunity in early inflammatory bowel disease? Early stage inflammatory bowel disease: the actual management.
MedLine Citation:
PMID:  23867949     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Traditionally therapy for inflammatory bowel disease (IBD) encompassed a sequential approach with subjects treated with 5-ASA products and/or corticosteroids initially, and only where failing such treatment, moving on to immunomodulator or biologic therapy. In the rheumatologic literature the importance of the early introduction of immunosuppressive therapies for inflammatory arthropathies has been increasingly recognized, however this concept remains much debated in IBD with no clear consensus on the optimal therapeutic approach. In this review we discuss how the natural history of IBD provides a rationale for the early introduction of the most effective therapy. We outline how the experience of early immunosuppressive therapy in rheumatoid arthritis informs therapeutic decision making in IBD. We review the evolving treatment strategies in IBD and the current evidence supporting the introduction of immunosuppressive treatment soon after IBD diagnosis. Finally we discuss the importance of selecting appropriate therapeutic endpoints in IBD and review the potential risks and benefits of early immunosuppressive treatment strategies in IBD.
Authors:
D Kevans; G Van Assche
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Minerva gastroenterologica e dietologica     Volume:  59     ISSN:  1121-421X     ISO Abbreviation:  Minerva Gastroenterol Dietol     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-07-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9109791     Medline TA:  Minerva Gastroenterol Dietol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  299-312     Citation Subset:  IM    
Affiliation:
Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, Ontario, Canada - GVanAssche@mtsinai.on.ca.
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