Extraintestinal Manifestations of Crohn’s DiseaseJuillerat P. · Mottet C. · Pittet V. · Froehlich F. · Felley C. · Gonvers J.-J. · Vader J.-P. · Michetti P.
aDivision of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, bGastrointestinal Department, University of Basle, Basle, and cHealthcare Evaluation Unit, Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
In each case of extraintestinal manifestations of Crohn’s disease, active disease, if present, should be treated to induce remission, which may positively influence the course of most concomitant extraintestinal manifestations. For some extraintestinal manifestations, however, a specific treatment should be introduced. This latter part of disease management will be discussed in this chapter, in particular for pyoderma gangrenosum, uveitis, spondylarthropathy – axial arthropathy – and primary sclerosing cholangitis, which have also been described in quiescent Crohn’s disease. Few new drugs for the treatment of extraintestinal manifestations of Crohn’s disease have been developed in the past and only the role of infliximab has increased in Crohn’s disease-related extraintestinal manifestations. Drugs specifically aimed at this treatment, stemming from a few randomized controlled studies or case series, are sulfasalazine, 5-ASA, corticosteroids, azathioprine or 6-mercaptopurine, methotrexate, infliximab, adalimumab, etanercept and cyclosporine or tacrolimus. Unfortunately, because of the paucity of data in this field, the best evidence presented and discussed in this article for the treatment of these extraintestinal manifestations is extrapolated from patients that for the most part did not suffer from Crohn’s disease.
Pascal Juillerat, MD
Division of Gastroenterology and Hepatology
Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46
CH–1011 Lausanne (Switzerland)
Tel. +41 21 314 05 64, Fax +41 21 314 06 84, E-Mail email@example.com
Published online: February 7, 2008
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 0, Number of References : 106
Digestion (International Journal of Gastroenterology)
Vol. 76, No. 2, Year 2007 (Cover Date: February 2008)
Journal Editor: Beglinger, C. (Basel), Göke, B. (Munich)
ISSN: 0012–2823 (Print), eISSN: 1421–9867 (Online)
For additional information: http://www.karger.com/DIG