Medical treatment of active Crohn's disease includes sulfasalazine or aminosalicylates, conrticosteroids, immunomodulators, and antibiotics. In 1997, further reports on the efficacy of the semisynthetic corticosteroid, budesonide, were published; this drug was also compared with mesalamine. Ciprofloxacin, a quinolone antibotic, was compared with measalamine in a French study. For refractory disease, preliminary results with the immunosuppressive agent tacrolimus appeared promising. The most dramatic improvement in the acute treatment of Crohn's disease has been observed with the chimeric antibody against tumor necrosis factor-alpha; cA2. This antibody was not only effective in the induction of remission, but it healed enterocultaneous fistulae as well. Repeated infusions of cA2 maintained clinical remission in the majority of patients who had responded to initial cA2 treatment. Besides the cA2 study, other maintenace studies have mainly focused on the prolonged use of mesalamine, both following medically induced remission and after surgical resection. The results remain controversial.
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