Informasjon

Legemidler ved Crohns sykdom

Immundempende midler

Ved hissige betennelser der standardbehandlingen virker dårlig, har man tidligere ofte brukt immundempende midler i langtidsbehandlingen. Disse legemidlene demper immunsystemet og dermed også betennelsesreaksjonen som forårsaker Crohns sykdom. Førstevalget i Norge har vært azatioprin. Alternativer er merkaptopurin og metotreksat.

Immunhemmere som azatioprin eller metotreksat brukes i dag stadig mindre i behandlingen av Crohns sykdom.

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Jeg har lest og akseptert Brukervilkår ved kjøp av NEL-dokumenter

Dette dokumentet er basert på det profesjonelle dokumentet "Crohns sykdom". Referanselisten for dette dokumentet vises nedenfor.

Veauthier B, Hornecker JR. Crohn's Disease: Diagnosis and Management. Am Fam Physician. 2018;98(11):661-669. PubMed
Maaser C, Sturm A, Vavricka SR, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. Journal of Crohn's and Colitis, Volume 13, Issue 2, February 2019, Pages 144–164K. DOI: 10.1093/ecco-jcc/jjy113 DOI
Buer LCT, Moum BA. Inflammatorisk tarmsykdom – diagnostikk og behandling. Indremedisineren, publisert 10.08.2016. indremedisineren.no
Kalla R, Ventham NT, Satsangi J, et al. Crohn's disease. BMJ. 2014;349:g6670. doi: 10.1136/bmj.g6670 DOI
Halme L, Paavola-Sakki P, Turunen U, et. al. Family and twin studies in inflammatory bowel disease. World J Gastroenterol 2009; 12: 3668-72. PubMed
Abraham C, Cho JH. Inflammatory bowel disease. N Engl J Med 2009; 361: 2066-78. New England Journal of Medicine
Takeuchi K, Smale S, Premchand P, et al. Prevalence and mechanism of nonsteroidal anti-inflammatory drug-induced clinical relapse in patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2006; 4: 196-202. PubMed
Marks DJ, Rahman FZ, Sewell GW, Segal AW. Crohn's disease: an immune deficiency state. Clin Rev Allergy Immunol. 2010 Feb;38(1):20-31. doi: 10.1007/s12016-009-8133-2. DOI
Yamamato T. The clinical value of faecal calprotectin and lactoferrin measurement in postoperative Crohn's disease. United European Gastroenterology Journal 2015; 3: 5-10. doi:10.1177/2050640614558106 DOI
de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI consensus workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63:743-752. PubMed
Holtman GA, Lisman-van Leeuwen Y, Reitsma JB, et al. Noninvasive tests for inflammatory bowel disease: A meta-analysis. Pediatrics 2016; 137:1-11. doi: 10.1542/peds.2015-2126 DOI
Jahnsen J, Røseth AG, Aadland A. Måling av kalprotektin i feces. Tidsskr Nor Legeforen 2009; 129: 743-5. Tidsskrift for Den norske legeforening
van Rheenen PF, de Vijver EV, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ 2010; 341: c3369. BMJ (DOI)
Yang Z, Clark N, Park KT. Effectiveness and cost-effectiveness of measuring fecal calprotectin in diagnosis of inflammatory bowel disease in adults and children. Clin Gastroenterol Hepatol 2014; 12: 253-62. pmid:23883663 PubMed
Kennedy NA, Jones G-R, Plevris N, et al. Association between level of fecal calprotectin and progression of Crohn's disease. Clinical Gastroenterology and Hepatology Available online 14 February 2019. doi:10.1016/j.cgh.2019.02.017 DOI
Solem CA, Loftus EV Jr, Fletcher JG, et al. Small-bowel imaging in Crohn's disease: a prospective, blinded, 4-way comparison trial. Gastrointest Endosc 2008; 68: 255-66. PubMed
Horsthuis K, Bipat S, Bennink RJ, Stoker J. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology 2008; 247: 64-79. Radiology
Wang H, Zhao J, Zhu W, et al. Ultrasound as a diagnostic tool in detecting active Crohn's disease: a meta-analysis of prospective studies. Eur Radiol. 2014 ;24(1):26-33. doi: 10.1007/s00330-013-2973-0. DOI
Reese G, Woodfield G, Patel PH. Crohn's disease. BMJ Best Practice, last updated Feb 2018.
Benchimol EI, Seow CH, Steinhart AH, Griffiths AM. Traditional corticosteroids for induction of remission in Crohn's disease. Cochrane Database Syst Rev 2008; 16: CD006792. pmid:18425970 PubMed
Townsend CM, Parker CE, MacDonald JK, et al. Antibiotics for induction and maintenance of remission in Crohn`s disease. Cochrane Database Syst Rev. 2019 Feb 7;2:CD012730. doi: 10.1002/14651858.CD012730.pub2. DOI
Solberg IC, Vatn MH, Høie O, et al. Clinical course in Crohn's disease: results of a Norwegian population-based ten-year follow-up study. Clin Gastroenterol Hepatol. 2007 Dec;5(12):1430-8. PMID: 18054751 PubMed
Steinhart AH, Ewe K, Griffiths AM et al. Corticosteroids for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2008, Issue 4. The Cochrane Library
Anisdahl K, Svatun Lirhus S, Medhus AW, Moum B, Melberg HO, Høivik ML. First-line biologic treatment of inflammatory bowel disease during the first 12 months after diagnosis from 2010 to 2016: a Norwegian nationwide registry study. Scand J Gastroenterol. 2021;56(10):1163-1168. PubMed
Lirhus SS, Høivik ML, Moum B, Melberg HO. Regional differences in anti-TNF-α therapy and surgery in the treatment of inflammatory bowel disease patients: a Norwegian nationwide cohort study. Scand J Gastroenterol. 2018 Aug;53(8):952-957. PubMed
To N, Gracie DJ, Ford AC. The Importance of Smoking Cessation in Improving Disease Course in Crohn's Disease. Am J Gastroenterol. 2016;111(8):1198. PubMed
Lambert B, Lemberg DA, Leach ST, Day AS. Longer-term outcomes of nutritional management of Crohn's disease in children. Dig Dis Sci 2012; 57: 2171-7. pmid:22661250 PubMed
Buchanan E, Gaunt WW, Cardigan T et al. The use of exclusive enteral nutrition for induction of remission in children with Crohn's disease demonstrates that disease phenotype does not influence clinical remission. Aliment Pharmacol Ther 2009; 30: 501-7. pmid:19549288 PubMed
Narula N, Dhillon A, Zhang D, Sherlock ME, Tondeur M, Zachos M. Enteral nutritional therapy for induction of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2018, Issue 4. The Cochrane Library
Akobeng AK, Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database of Syst Rev 2007; 3: CD005984. doi:10.1002/14651858.CD005984.pub2 DOI
Zhan YL, Zhan YA, Dai SX. Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review. Clin Nutr. 2017 May 24 . pmid:28587774 PubMed
Torres J, Bonovas S, Doherty G, et al. ECCO Guidelines on Therapeutics in Crohn's Disease: medical treatment. European Crohn’s and Colitis Organisation (ECCO), 2019. outlook.office365.com
Rezaie A, Kuenzig ME, Benchimol EI, Griffiths AM, Otley AR, Steinhart AH, Kaplan GG, Seow CH. Budesonide for induction of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No.: CD000296. DOI: 10.1002/14651858.CD000296.pub4 DOI
Kuenzig ME, Rezaie A, Seow CH, et al. Budesonide for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev. 2014 ;8:CD002913. doi: 10.1002/14651858.CD002913.pub3 DOI
Ford AC, Peyrin-Biroulet L. Opportunistic infections with anti-tumor necrosis factor-alpha therapy in inflammatory bowel disease: meta-analysis of randomized controlled trials. Am J Gastroenterol 2013 May 7. pmid:23649185. PubMed
Singh S, Garg SK, Pardi DS, et al. Comparative efficacy of pharmacologic interventions in preventing relapse of Crohn's disease after surgery: a systematic review and network meta-analysis. Gastroenterology. 2015 ;148(1):64-76.e2; quiz e14. doi: 10.1053/j.gastro.2014.09.031.
Rutgeerts P, Hiele M, Geboes K, et al. Controlled trial of metronidazole treatment for prevention of Crohn's recurrence after ileal resection. Gastroenterology. 1995 Jun;108(6):1617-21. . pmid:7768364 PubMed
Herfarth H, Barnes EL, Valentine JF, et al. Methotrexate Is Not Superior to Placebo in Maintaining Steroid-Free Response or Remission in Ulcerative Colitis. Gastroenterology. 2018;155(4):1098-1108.e9.
Conway R, Low C, Coughlan RJ, et al. Methotrexate use and risk of lung disease in psoriasis, psoriatic arthritis, and inflammatory bowel disease: systematic literature review and meta-analysis of randomised controlled trials. BMJ. 2015 Mar 13;350:h1269. doi: 10.1136/bmj.h1269.
Stidham RW, Lee TC, Higgins PD, et al. Systematic review with network meta-analysis: the efficacy of anti-TNF agents for the treatment of Crohn's disease. Aliment Pharmacol Ther. 2014 Jun;39(12):1349-62. doi: 10.1111/apt.12749. DOI
Gionchetti P, Dignass A, Danese S, et al. 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: Part 2: Surgical management and special situations. J Crohns Colitis. 2017 Feb;11(2):135-149. PubMed
Tøttrup A. Laparoskopisk kirurgi ved inflammatorisk tarmsygdom. Ugeskr Læger 2010; 172: 2287. PubMed
Singh S, Ding N S, Mathis K L, et al (2015). Systematic review with meta-analysis: faecal diversion for management of perianal Crohn's disease. Alimentary Pharmacology & Therapeutics, 42: 783–792. doi: 10.1111/apt.13356 DOI
Prefontaine E, Sutherland LR, MacDonald JK, Cepoiu M. Azathioprine or 6-mercaptopurine for maintenance of remission in Crohn's disease. Cochrane Database of Syst Rev 2008; 1: CD000067. doi:10.1002/14651858.CD000067.pub2 DOI
Torres J, Boyapati RK, Kennedy NA, et al. Systematic Review of Effects of Withdrawal of Immunomodulators or Biologic Agents From Patients With Inflammatory Bowel Disease. Gastroenterology. 2015 ;149:1716-30. doi: 10.1053/j.gastro.2015.08.055. PMID:26381892 PubMed
Lofthus EV, Schoenfeld P, Sandborn WJ. The epidemiology and natural history of Crohn's disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther 2002; 16: 51-60. PubMed
Nørgård B, Pedersen L, Christensen LA, Sørensen HT. Therapeutic drug use in women with Crohn`s disease and birth outcomes: a danish nationwide cohort study. Am J Gastroenterol 2007; 102: 1406-13. PubMed
Grimstad T, Norheim KB. Utmattelse ved inflammatorisk tarmsykdom. Tidsskr Nor Lægeforen 2016; 136: 1721-24. pmid:27830906 PubMed
Grimstad T, Norheim KB, Isaksen K et al. Fatigue in Newly Diagnosed Inflammatory Bowel Disease. J Crohns Colitis 2015; 9: 725-30. pmid:25994356 PubMed
Hovde O, Kempski-Monstad I, Smastuen MC, et al. Mortality and causes of death in Crohn`s disease: results from 20 years of follow-up in the IBSEN study. Gut. 2013 Jun 6. PMID: 23744613. PubMed
Olén O, Askling J, Sachs MC et al. Mortality in adult-onset and elderly-onset IBD: a nationwide register-based cohort study 1964-2014. Gut 2019. Epub. 317572 pmid:31092591 PubMed
Ewe K, Herfarth C, Malchow H, Jesdinsky HJ. Postoperative recurrence of Crohn's disease in relation to radicality of operation and sulphasalazine prophylaxis: a multicenter trial. Digestion 1989; 42: 224-32. PubMed

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Legemidler ved Crohns sykdom

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Immundempende midler

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Legemidler ved Crohns sykdom

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Immundempende midler

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