Biological response modifiers for the treatment of Crohn's disease.
Although standard medical therapy in Crohn's disease is efficient in most patients, a substantial proportion of patients suffering from chronic active disease do not adequately respond to standard therapy. In these patients, alternative regimens have to be considered. Due to the major advances in understanding the pathogenesis of this complex disease involving genetic, environmental, microbial and immunological factors, various new biological therapies targeting key mechanisms have emerged. In this review, a critical appraisal of modern therapeutical concepts will be presented, focusing on antibody and small inhibitory molecule therapies, including inhibition of TNF-alpha and other pro-inflammatory cytokines, adhesion molecules and T cell activation, as well as hormonal therapies.
Siveke
J T
JT
II. Med. Klinik, Klinikum rechts der Isar Technische Universität München, Germany.
Folwaczny
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D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D002448:Cell Adhesion / Q000187:drug effects; D015815:Cell Adhesion Molecules / Q000037:antagonists & inhibitors; D017326:Clinical Trials, Phase III as Topic; D003424:Crohn Disease / Q000188:drug therapy*; D016207:Cytokines / Q000037:antagonists & inhibitors; D019314:Dehydroepiandrosterone Sulfate / Q000627:therapeutic use; D004353:Drug Evaluation, Preclinical; D006133:Growth Substances; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008213:Lymphocyte Activation / Q000187:drug effects; D051379:Mice; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D015815:Cell Adhesion Molecules; D016207:Cytokines; D006133:Growth Substances; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D019314:Dehydroepiandrosterone Sulfate