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首页> 外文期刊>The Open Pediatric Medicine Journal >The Management of Paediatric Crohn’s Disease: Addressing Unmet Needs
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The Management of Paediatric Crohn’s Disease: Addressing Unmet Needs

机译：小儿克罗恩病的治疗：解决未满足的需求

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Abstract: Paediatric Crohn’s disease (CD) affects 5 in 100,000 children in the US and Europe and can result in growth retardationand delayed sexual development. Therefore, early diagnosis and treatment is critical, with the goal being maintenanceof symptomatic remission and a change in disease course. Conventional treatment relies on aminosalicylate maintenancetherapy with corticosteroids to control acute exacerbations and immunomodulators for steroid-resistant or frequentlyrelapsing disease. Infliximab has demonstrated efficacy in moderately to severely active paediatric CD, with88.4% patients in clinical response and 58.9% in clinical remission at week 10. Significant improvements in quality oflife, height, reduction in corticosteroid use and mucosal healing were observed with infliximab. Traditional ‘step-up’treatment strategy may be suboptimal because relapse and steroid dependency/resistance rates remain high. A ‘top down’approach using biologic therapy earlier may suppress intestinal inflammation and promote prolonged and stable remission,but safety issues need to be considered.
机译：摘要：小儿克罗恩病（CD）在美国和欧洲影响100,000名儿童中的5名，并可能导致发育迟缓和性发育延迟。因此，早期诊断和治疗至关重要，其目标是维持症状缓解和改变病程。常规治疗依靠使用糖皮质激素的氨基水杨酸酯维持疗法来控制针对类固醇抗药性或频繁复发的疾病的急性加重和免疫调节剂。英夫利昔单抗已显示出对中度至重度儿科CD的疗效，第10周时，其临床反应率为88.4％，临床缓解率为58.9％，观察到英夫利昔单抗的生活质量，身高，皮质类固醇使用减少和粘膜愈合显着改善。传统的“逐步治疗”策略可能不理想，因为复发和类固醇依赖性/耐药率仍然很高。较早采用生物疗法的“自上而下”的方法可能会抑制肠道炎症并促进长期稳定的缓解，但需要考虑安全性问题。

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