Clinical, biological, and endoscopic picture of attacks of Crohn's disease

Modigliani, R; Mary, Jean‐Yves; Simon, Jean-François; Cortot, Antoine; Soulé, Jean–Claude; Gendre, Jean–Pierre; René, E

doi:10.1016/0016-5085(90)90002-i

Cited by 651 publications

(202 citation statements)

References 19 publications

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“…The GETAID group has repeatedly shown that endoscopic activity of Crohn's disease correlates either poorly or not at all with a clinical disease activity index 6,7,29 . Similarly in ulcerative colitis, macroscopic changes at colonoscopy have correlated poorly with the PT clinical index, so an objective measure of inflammation is not necessarily reflective of a patient's symptoms 30 .…”

Section: Discussionmentioning

confidence: 99%

The Manitoba IBD Index: Evidence for a New and Simple Indicator of IBD Activity

et al. 2009

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Section: Discussionmentioning

confidence: 99%

The Manitoba IBD Index: Evidence for a New and Simple Indicator of IBD Activity

et al. 2009

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“…Higher doses of prednisone (1 mg / kg) or methyl prednisolone (1 mg / kg) have had somewhat higher response rates of 80 -90 % (ref. (54,92) ). ere are no standards for corticosteroid tapering (15) .…”

Section: Mild To Moderate Active Diseasementioning

confidence: 99%

“…Endoscopic appearance, to date, has not correlated with clinical disease activity a er steroid therapy (54) , but there is a closer correlation between therapeutic e ects and mucosal healing with anti-TNF monoclonal antibodies (55) . Upper GI endoscopic ndings of focal gastritis have recently been described that are indicative of CD and separate from the ndings related to H. pylori (33) .…”

Section: Generalmentioning

confidence: 99%

Management of Crohn's Disease in Adults

2009

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Guidelines for clinical practice are intended to suggest preferable approaches to particular medical problems as established by interpretation and collation of scientifi cally valid research, derived from extensive review of published literature. When data that will withstand objective scrutiny are not available, a recommendation may be made based on a consensus of experts. Guidelines are intended to apply to the clinical situation for all physicians without regard to specialty. Guidelines are intended to be fl exible, not necessarily indicating the only acceptable approach, and should be distinguished from standards of care that are infl exible and rarely violated. Given the wide range of choices in any health-care problem, the physician should select the course best suited to the individual patient and the clinical situation presented. These guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee. Expert opinion is solicited from the outset for the document. The quality of evidence upon which a specifi c recommendation is based is as follows: Grade A: Homogeneous evidence from multiple well-designed randomized (therapeutic) or cohort (descriptive) controlled trials, each involving a number of participants to be of suffi cient statistical power. Grade B: Evidence from at least one large well-designed clinical trial with or without randomization, from cohort or case -control analytic studies, or well-designed meta-analysis. Grade C: Evidence based on clinical experience, descriptive studies, or reports of expert committees. The Committee reviews guidelines in depth, with participation from experienced clinicians and others in related fi elds. The fi nal recommendations are based on the data available at the time of the production of the document and may be updated with pertinent scientifi c developments at a later time.

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“…In addition; although corticosteroids are able to induce clinical remission; but they are associated with lots of adverse events; and they are unable to induce mucosal healing and long term use is discouraged [7]. Azathioprine (AZA) is a potent drug to maintain clinical remission in CD; but it has a slow onset of action and long term benefit on the natural history of the disease became conflictive [8,9].…”

Section: Introductionmentioning

confidence: 99%