An Update on the Treatment of Crohn's Disease

Abstract

Infliximab (IFX), which is an anti-TNF biologic, is becoming a standard medication for the treatment of Crohn's disease (CD). IFX appears to be more effective than conventional medications in inducing intestinal mucosal healing, and maintaining remission as scheduled maintenance therapy when administered at 8-week intervals, offering better long-term control of symptoms. Significantly, mucosal healing is associated with lower flare-up rates, the need for surgical intervention, and hospitalization rate. As a result, the long-term prognosis and QoL of CD patients are improved. However, there is significant concern about the long-term efficacy and safety of IFX, which needs to be addressed such as through immunomodulator therapy to minimize the loss of efficacy during maintenance IFX therapy.
Recently, a granulocytapheresis therapy (GCAP), which is fundamentally different from drug based medication, has become available for clinical application in patients with IBD. GCAP is viewed as an alternative therapy for patients with CD, and is very effective for the treatment of IBD; it has been accepted as a standard therapy for patients with active ulcerative colitis, and its use is now extending to CD. Further investigations are required for the use of GCAP in treating patients with IBD.