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http://hdl.handle.net/10400.23/418
Título: | Decisões clínicas na doença de Crohn |
Outros títulos: | linical challenges in Crohn s disease |
Autor: | Magro, F Correia, L Lago, P Macedo, G Peixe, P Portela, F Ferreira, A Gonçalves, R et al |
Palavras-chave: | Doença de Crohn |
Data: | 2012 |
Editora: | Sociedade Portuguesa de Gastrenterologia |
Citação: | J Port Gastrenterol.2012;19(2):71-88 |
Resumo: | Introduction: Crohn s disease is a chronic inflammatory disease from gastrointestinal tract. The increase in incidence and heterogeneity of this pathology, with different presentations and prognostics leads to a constant concern in developing and improving its classification and treatment. Objectives: To establish recommendations (based on level of evidence and recommendation grades) to 5 questions considered as the clinical challenges of the therapeutic approach in Crohn s disease. Methods: The methodology adopted by the working group DC2 (Desafios Clínicos na Doença de Crohn) was based on the selection of 5 questions, by voting, and establishing recommendations to each question proposed to each subgroup. Discussion and approval of reflexions and final recommendations was carried out in a consensus meeting. Conclusion: It has been possible to base conclusions about the questions under study on evidence, being recommended: 1) having Crohn s disease under 40 years old, structuring phenotype disease and anal disease are predictive factors of bad prognostic; 2) it is possible to consider suspension of biologics in patients with endoscopic remission and normal biomarkers; 3) patients with biochemical markers of disease activity (CRP and calprotectina) have more probability of relapse; 4) in failure of biologics it is essential to assure that treatment with the first drug was optimized: with infliximab it s demonstrated that either reduction of the administration range or increasing the dose allows to recover the response in the majority of patients; as for adalimumab, patients should change from bimonthly to weekly administrations; 5) in case of Crohn s disease with intestinal surgery, use of therapeutic to reduce postoperative recurrence is indicated, particularly immunosupressors and biologics. |
Peer review: | yes |
URI: | http://hdl.handle.net/10400.23/418 |
Aparece nas colecções: | HB - GAS - Artigos |
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