Prakt. lékáren. 2009; 5(4): 164-167
Pharmacotherapy of inflammatory bowel diseases
- IV. interní klinika VFN a 1. LF UK, Praha
Aminosalicylates, corticosteroids, immunosuppressants, and recently also biological therapy are the mainstays of pharmacotherapy of
inflammatory bowel diseases (IBD). Aminosalicylates (sulphasalazine, mesalazine) are essential drugs for both aggressive and maintenance
treatment of patients with ulcerative colitis. They are administered orally, in limited disease they may also be administered locally
in the form of suppository or rectal enema. Corticosteroids with systemic effect have a strong anti-inflammatory effect and are used in
oral or parenteral therapy in patients with a severe course of intestinal inflammations. The treatment with corticosteroids is burdened
with a risk of serious adverse effects the intensity of which increases with the dose and duration of administration. Corticosteroids are
of no importance in preventing the relapse of IBD. An alternative of the treatment of ileocaecal Crohn's disease with a mild to moderate
inflammatory activity are topical steroids (budesonide) administered orally. Immunosuppressants, particularly thiopurines, are indicated
in the treatment of chronically active forms of IBD, in the case of some extraintestinal manifestations, and in the treatment of fistulating
Crohn's disease. They are used in the practice mainly because of their corticoid-sparing effect. In the last ten years, the options of medical
treatment for IBD have been broadened to include biological therapy (infliximab and adalimumab) which is performed in the Czech
Republic in specialized centres. In a high proportion of patients unresponsive to conventional treatment with corticosteroids and immunosuppressants,
the initiation of biological therapy results in improvement in their condition or in achieving remission.
Keywords: Crohn's disease, ulcerative colitis, pharmacotherapy, inflammatory bowel diseases.
Published: August 1, 2009 Show citation
References
- Liechtenstein GR, Kamm MA, Sandborn WJ, et al. MMX mesalazine for the induction of remission of mild-to-moderately active ulcerative colitis: efficacy and tolerability in specific patient subpopulation. Aliment Pharmacol Ther 2008; 27(11): 1094-1102.
Go to original source... 
Go to PubMed... - Pearson DC, May GR, Fick GH, Sutherland LR. Azathioprine and 6-mercaptopurine on Crohn´s disease. A meta-analysis. Ann Intern Med 1995; 123: 132-142. Go to original source... Go to PubMed...
- Zbořil V. Biologická terapie v gastroenterologii. Čes a Slov Gastroent a Hepatol 2007; 61(6): 293-296.
- Lukáš M. Biologická terapie idiopatických střevních zánětů. Remedia 2007; 17(4): 34-35.
- Lukáš M, Ďuricova D, Bortlik M, et al. Doporučení pro podávání biologické léčby u nemocných s idiopatických střevních zánětů. Čes a Slov Gastroent a Hepatol 2008; 62(5): 283-289.