Induction Maintenance Minimal evidence Investigational No role IFX or ADA IFX or ADA CZP Spherical carbon adsorbent Steroids aAntibiotics b6-MP Tacrolimus Stem cells Aminosalicylates – bAZA Cyclosporine – – –…
Fig. 38.1 Chemical structures of sulfasalazine and 5-ASA derivatives [2, 3] Mechanism of Action Sulfasalazine has been suggested to exert its clinical effects through anti-inflammatory, immunosuppressive, and bacteriostatic mechanisms. Downregulation…
Benefits of mucosal healing Unresolved issues of mucosal healing Decreased clinical relapse How much mucosal healing is required to impact outcomes? Decreased hospitalizations Can mucosal healing be achieved in most…
Fig. 45.1 Tc-99 m HMPAO WBC scintigraphy in a patient with ulcerative colitis (left) whole-body image and (right) a detail of the abdomen. Rapid migration of lymphocytes from the peripheral…
Drug Risk of Infection Comments Corticosteroids • Serious infections OR 2.21 (1.46–3.34) from TREAT registry of Crohn’s disease patients [7, 19] • Independently associated with serious infections [28] • Infections reported: fungal [10],…
Fig. 49.1 Scanning electron photomicrographs of carriers that have adsorbed leukocytes during leukocytapheresis. (a) The Adacolumn is filled with cellulose acetate beads as leukocytapheresis carriers that selectively adsorb granulocytes, monocytes/macrophages,…
Fig. 33.1 The manufacturing process of certolizumab pegol Effectiveness and Safety in Crohn’s Disease: Randomized Controlled Trials PRECISE Studies Two randomized placebo-controlled double-blind Phase III studies , PRECISE 1 and…
Fig. 30.1 Azathioprine metabolism . TPMT thiopurine-S-methyl transferase Pharmacologic Mechanism of Thiopurines 6-TGNs affect the immune response via several potential mechanisms. They are incorporated into DNA, thereby inhibiting its synthesis…
Fig. 26.1 Utility scores for Crohn’s disease versus the general population. Adapted from Rocchi 2012 Nov;26(11):811–7 Cost–Utility Analysis In cost–utility analysis [2], utility scores are converted to quality adjusted life…
Fig. 3.1 Structure of the epithelial barrier . (a) Transmission electron micrograph depicting the apical junctional complex between two mouse enterocytes. From apical to basal, the apical junctional complex consists…
