Review article: moving towards common therapeutic goals in Crohn's disease and rheumatoid arthritis

Abstract

Novel therapeutic strategies in CD based on tight control of objective signs of inflammation are expected to change disease course and patients' lives by halting progression or, ideally, preventing the occurrence of bowel damage. Most of these strategies require validation in prospective studies, whereas several disease-modification trials have addressed these issues in rheumatoid arthritis over the last decade. The recent approval of new drugs in CD such as vedolizumab and ustekinumab should facilitate initiation of disease-modification trials in CD in the near future.

Long‐term efficacy and safety of ustekinumab in 122 refractory Crohn's disease patients: a multicentre experience

“…In the present study, an endoscopic evaluation was available in 28/47 (60%) patients with a mucosal healing in 11/28 (39%) patients. These results clearly underline the sustained efficacy of new molecules in CD such as ustekinumab, providing new medical therapeutic options to change disease course and prevent bowel damage and disability . Like in previous randomised and controlled studies in CD and chronic immune‐mediated inflammatory diseases, long‐term ustekinumab treatment was well tolerated in CD patients .…”

“…Moreover, we used ustekinumab failure‐free persistence as primary objective, that may be considered as a surrogate outcome. However, long‐term treatment maintenance without any major event meets the real‐life expectations of gastroenterologists and CD patients, who aim to avoid intestinal damage and progressive disability to improve quality of life . Furthermore, we reported objective response to ustekinumab treatment with 39% of the patient with a mucosal healing and 82% with an endoscopic improvement.…”

Early intervention in Crohn’s disease: towards disease modification trials

“…Several definitions of early RA have been proposed29: either as a duration of disease/symptoms of less than 6 months30 or no more than 1 year of disease duration together with no previous use of DMARD 31. Clinical studies investigating whether early introduction of immunosuppressants and/or biologics at the earliest stage of the disease show that between 70% and 90% of patients treated with infliximab or etanercept achieve disease remission in the short term (table 1).…”

The Risk of Rheumatoid Arthritis among Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-analysis

“…RA is a chronic and progressive disease; early diagnosis and intervention are essential for better prognosis. The management strategy of RA has focused on the early identification of high-risk patients [57,58]. Rheumatoid arthritis is currently diagnosed mainly according to the 2010 European However, these typical symptoms and signs may be lacking and RA-specific marker such as rheumatoid factor and anti-citrullinated protein antibody may be negative in the patients with RA especially during the early phase [60,61].…”