MEDICAL THERAPY FOR CROHNS-DISEASE

Medical treatment of active Crohn's disease includes sulfasalazine or aminosalicylates, corticosteroids, immunomodulators, and antibiotics. In 1997, further reports on the efficacy of the semisynthetic corticos teroid, budesonide, were published; this drug was also compared with m esalamine. Ciprofloxacin, a quinolone antibiotic, was compared with me salamine in a French study. For refractory disease, preliminary result s with the immunosuppressive agent tacrolimus appeared promising. The most dramatic improvement in the acute treatment of Crohn's disease ha s been observed with the chimeric antibody against tumor necrosis fact or-alpha cA2. This antibody was not only effective in the induction of remission, but it healed enterocutaneous fistulae as well. Repeated i nfusions of cA2 maintained clinical remission in the majority of patie nts who had responded to initial cA2 treatment. Besides the cA2 study, other maintenance studies have mainly focused on the prolonged use of mesalamine, both following medically induced remission and after surg ical resection. The results remain controversial.