Natural history of Crohn's disease: is the tide beginning to turn?

摘要

An article recently published in Gut entitled "Natural history of Crohn's disease in a population-based cohort from Cardiff (1986-2003): a study of changes in medical treatment and surgical resection rates claims that the increased use of immunosuppressive therapy has been associated with lower intestinal resection rates in Crohn's Disease. Can this be so? We have known for many years that therapies such as methotrexate, azathioprine and biologies are effective in inducing and maintaining remission in Crohn's patients in short term studies. But have these drugs been able to control Crohn's disease to the extent that its natural history is modified? If so, the benefits would be considerable.