Treatment of inflammatory bowel disease: A review of medical therapy

Patricia L. Kozuch, Stephen B. Hanauer*

*Corresponding author for this work

Research output: Contribution to journalReview article

167 Scopus citations

Abstract

Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases of the gastrointestinal tract. While a cure remains elusive, both can be treated with medications that induce and maintain remission. With the recent advent of therapies that inhibit tumor necrosis factor (TNF) alpha the overlap in medical therapies for UC and CD has become greater. Although 5-ASA agents have been a mainstay in the treatment of both CD and UC, the data for their efficacy in patients with CD, particularly as maintenance therapy, are equivocal. Antibiotics may have a limited role in the treatment of colonic CD. Steroids continue to be the first choice to treat active disease not responsive to other more conservative therapy; nonsystemic steroids such as oral and rectal budesonide for ileal and right-sided CD and distal UC respectively are also effective in mild-moderate disease. 6-mercaptopurine (6-MP) and its prodrug azathioprine are steroid-sparing immunomodulators effective in the maintenance of remission of both CD and UC, while methotrexate may be used in both induction and maintenance of CD. Infliximab and adalimumab are anti-TNF agents approved in the US and Europe for the treatment of Crohn's disease, and infliximab is also approved for the treatment of UC.

Original languageEnglish (US)
Pages (from-to)354-377
Number of pages24
JournalWorld Journal of Gastroenterology
Volume14
Issue number3
DOIs
StatePublished - Jan 21 2008

Keywords

  • Crohn's disease
  • Inflammatory bowel disease
  • Medical therapy
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

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