Inflammatory bowel disease: Efficient remission maintenance is crucial for cost containment
The inflammatory bowel diseases (IBD) are chronic incurable inflammatory disorders of the gut. Some 10% run a downhill course, requiring emergency medical support and often surgery; another small subset are monogenic, and, threatening pediatric patients, are the challenge of these days. The majority...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421109/ https://www.ncbi.nlm.nih.gov/pubmed/28533920 http://dx.doi.org/10.4292/wjgpt.v8.i2.114 |
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author | Actis, Giovanni C Pellicano, Rinaldo |
author_facet | Actis, Giovanni C Pellicano, Rinaldo |
author_sort | Actis, Giovanni C |
collection | PubMed |
description | The inflammatory bowel diseases (IBD) are chronic incurable inflammatory disorders of the gut. Some 10% run a downhill course, requiring emergency medical support and often surgery; another small subset are monogenic, and, threatening pediatric patients, are the challenge of these days. The majority of the IBDs, however, are polygenic low-penetrance diseases, running a lifetime waxing-and-waning course. The prevalent trend is towards a slow worsening and steady cost increase. Each and all drugs of the available arsenal exhibit strengths and weaknesses: Mesalamines are chiefly effectively for mild-moderate colitis, and do not work in Crohn’s; steroids do not control some 40% of the ulcerative colitis cases, and are not indicated for Crohn’s; thiopurines are effective in the maintenance of the IBDs but do not prevent relapses on withdrawal; biologics are still being used empirically (not monitored) causing further increase of their cost over that of hospitalization. Against all these caveats, two simple rules still hold true: Strict adherence maintenance and avoidance of colitogenic drugs. This matter is expanded in this minireview. |
format | Online Article Text |
id | pubmed-5421109 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-54211092017-05-22 Inflammatory bowel disease: Efficient remission maintenance is crucial for cost containment Actis, Giovanni C Pellicano, Rinaldo World J Gastrointest Pharmacol Ther Minireviews The inflammatory bowel diseases (IBD) are chronic incurable inflammatory disorders of the gut. Some 10% run a downhill course, requiring emergency medical support and often surgery; another small subset are monogenic, and, threatening pediatric patients, are the challenge of these days. The majority of the IBDs, however, are polygenic low-penetrance diseases, running a lifetime waxing-and-waning course. The prevalent trend is towards a slow worsening and steady cost increase. Each and all drugs of the available arsenal exhibit strengths and weaknesses: Mesalamines are chiefly effectively for mild-moderate colitis, and do not work in Crohn’s; steroids do not control some 40% of the ulcerative colitis cases, and are not indicated for Crohn’s; thiopurines are effective in the maintenance of the IBDs but do not prevent relapses on withdrawal; biologics are still being used empirically (not monitored) causing further increase of their cost over that of hospitalization. Against all these caveats, two simple rules still hold true: Strict adherence maintenance and avoidance of colitogenic drugs. This matter is expanded in this minireview. Baishideng Publishing Group Inc 2017-05-06 2017-05-06 /pmc/articles/PMC5421109/ /pubmed/28533920 http://dx.doi.org/10.4292/wjgpt.v8.i2.114 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Minireviews Actis, Giovanni C Pellicano, Rinaldo Inflammatory bowel disease: Efficient remission maintenance is crucial for cost containment |
title | Inflammatory bowel disease: Efficient remission maintenance is crucial for cost containment |
title_full | Inflammatory bowel disease: Efficient remission maintenance is crucial for cost containment |
title_fullStr | Inflammatory bowel disease: Efficient remission maintenance is crucial for cost containment |
title_full_unstemmed | Inflammatory bowel disease: Efficient remission maintenance is crucial for cost containment |
title_short | Inflammatory bowel disease: Efficient remission maintenance is crucial for cost containment |
title_sort | inflammatory bowel disease: efficient remission maintenance is crucial for cost containment |
topic | Minireviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421109/ https://www.ncbi.nlm.nih.gov/pubmed/28533920 http://dx.doi.org/10.4292/wjgpt.v8.i2.114 |
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