Novosti v zdravljenju kronične vnetne črevesne bolezni = What is new in therapy of inflammatory bowel disease
Ferkolj, Ivan
The goal of treating acute exacerbations of ulcerative colitis is to induce remission. Therapy should begin with an assessment of disease localisation, extent, severity and response to prior ...treatments. Mild to moderately active disease should be treated with oral mesalazine 3-4.5 g daily; while moderate to severe extensive colitis requires corticosteroid therapy. Distal disease can be treated either with topical mesalazine or topical corticosteroids or a combination of both. Severe to fulminant colitis requires hospitalisation and parenteral administration of corticosteroids. For ulcerative colitis, patientsshould be given 5-ASA compounds (mesalazin 2-3 g daily), which are very effective in the maintenance of remission. The medications which are usedto treat acute exacerbations of Crohn's disease are 5-ASA (3-4.5 g daily),antibiotics (metronidazole and pefloxacine), glucocorticoids and nutritional therapy. An oral controlled-release preparation of budesonide at adose of 9 mg per day is well-tolerated and effective therapy for active Crohn's disease of the ileum and proximal colon. The development of novel; highly effective forms of therapy such as infliximab, a monoclonal antibody against TNF alpha; has shown dramatic efficacy in the treatment of Crohn's disease. The efficacy of mesalazine or other 5-ASA compounds in maintaining remission or prevention of postoperative recurrence for patients with Crohn's disease is not as effective as in ulcerative colitis.
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