Abstract
Crohn’s disease (CD) is a chronic, disabling, progressive and destructive disease. The general goal of conventional step-up strategy in CD treatment is to treat and control symptoms. This strategy did not change the disease course and is now being replaced with a treat-to-target approach. Achieving deep remission (clinical remission and absence of mucosal ulcerations) is the target in CD in 2014. Inducing and maintaining deep remission is needed to prevent long-term outcomes such as bowel damage and disability in CD. Diagnostic delay is a common issue in CD and is associated with an increased risk of bowel damage over time. Identification of poor prognostic factors, risk stratification together with the development of “red flags” may result in early intervention with disease-modifying agents such as anti-TNF agents with the final aim of preventing overtreatment and avoiding undertreatment. Similar to rheumatoid arthritis, by catching the therapeutic window of opportunity in early CD and achieving deep remission, this could be the best way to change disease course (hospitalizations, surgeries, bowel damage, and disability) and patients’ life.
Keywords: Crohn’s disease, early disease, inflammatory bowel disease, therapy.
Current Drug Targets
Title:Catching the Therapeutic Window of Opportunity in Early Crohn`s Disease
Volume: 15 Issue: 11
Author(s): Silvio Danese, Gionata Fiorino, Carlos Fernandes and Laureal Peyrin-Biroulet
Affiliation:
Keywords: Crohn’s disease, early disease, inflammatory bowel disease, therapy.
Abstract: Crohn’s disease (CD) is a chronic, disabling, progressive and destructive disease. The general goal of conventional step-up strategy in CD treatment is to treat and control symptoms. This strategy did not change the disease course and is now being replaced with a treat-to-target approach. Achieving deep remission (clinical remission and absence of mucosal ulcerations) is the target in CD in 2014. Inducing and maintaining deep remission is needed to prevent long-term outcomes such as bowel damage and disability in CD. Diagnostic delay is a common issue in CD and is associated with an increased risk of bowel damage over time. Identification of poor prognostic factors, risk stratification together with the development of “red flags” may result in early intervention with disease-modifying agents such as anti-TNF agents with the final aim of preventing overtreatment and avoiding undertreatment. Similar to rheumatoid arthritis, by catching the therapeutic window of opportunity in early CD and achieving deep remission, this could be the best way to change disease course (hospitalizations, surgeries, bowel damage, and disability) and patients’ life.
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Cite this article as:
Danese Silvio, Fiorino Gionata, Fernandes Carlos and Peyrin-Biroulet Laureal, Catching the Therapeutic Window of Opportunity in Early Crohn`s Disease, Current Drug Targets 2014; 15 (11) . https://dx.doi.org/10.2174/1389450115666140908125738
DOI https://dx.doi.org/10.2174/1389450115666140908125738 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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