Utilize este identificador para referenciar este registo: 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://comum.rcaap.pt/handle/123456789/3879
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