title: [Drug treatment of Crohn's disease].
abstract: The medical management of Crohn's disease has changed in recent years, but the mainstay of treatment is still prednisone. A substantial fraction of steroid-treated patients are refractory to therapy and addition of azathioprine or methotrexate has a corticosteroid-sparing effect and increases duration of remission. Controlled ileal release budesonide (9 mg daily) induces clinical remission in 60-70% of patients with Crohn's ileitis or right-sided colitis, and continued budesonide treatment has a finite effect on the duration of remission. The efficacy of mesalazine in active Crohn's disease is limited and high doses are required (4000 mg/day). The role of mesalazine in Crohn's disease in remission is disputed, and there is no evidence of a corticosteroid-sparing effect.
authors.affiliation: Academisch Medisch Centrum/Universiteit van Amsterdam.
authors.forename: S J
authors.initials: SJ
authors.lastname: van Deventer
authors.forename: G N
authors.initials: GN
authors.lastname: Tytgat
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001379:Azathioprine / Q000008:administration & dosage; D019819:Budesonide / Q000008:administration & dosage; D002985:Clinical Protocols / Q000592:standards; D003424:Crohn Disease / Q000188:drug therapy*; D016572:Cyclosporine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D019804:Mesalamine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D019804:Mesalamine; D019819:Budesonide; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone; D008727:Methotrexate
vernacular_title: Medicamenteuze behandeling van de ziekte van Crohn.