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Pharmacologic therapy for inflammatory bowel disease refractory to steroids

Authors Martínez-Montiel MP, Casis-Herce B, Gómez-Gómez GJ, Masedo-González A, Bernardino C, Piedracoba C, Castellano-Tortajada G

Received 28 February 2015

Accepted for publication 11 May 2015

Published 17 August 2015 Volume 2015:8 Pages 257—269


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Andreas M Kaiser

MP Martínez-Montiel, B Casis-Herce , GJ Gómez-Gómez, A Masedo-González, C Yela-San Bernardino, C Piedracoba, G Castellano-Tortajada

Division of Gastroenterology, Hospital 12 de Octubre, Madrid, Spain

Abstract: Although corticosteroids are an effective treatment for induction of remission in inflammatory bowel disease (IBD), many patients are dependent on or refractory to corticosteroids. This review is based on scrutinizing current literature with emphasis on randomized controlled trials, meta-analyses, and Cochrane reviews on the management of IBD refractory to corticosteroids. Based on this evidence, we propose algorithms and optimization strategies for use of immunomodulator and biologic therapy in IBD refractory to corticosteroids.

Keywords: immunomodulators, anti-tumor necrosis factor alpha, Crohn's disease, ulcerative colitis, drug levels, treatment optimization

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