Management of Crohn's disease

835: 498: 914:, or granulocyte-monocyte colony stimulating factor (GM-CSF), has been shown to substantially improve health-related quality of life in pilot studies, measured by an increase in score on a 32-item IBD questionnaire. A recent Phase II trial showed that Sargramostim significantly decreased CD severity (48%, compared with 26% in the placebo group) and improved quality of life (40%, versus 19% for placebo). 122: 179:, which is typically dosed at 0.5 mg/kg for induction of remission in Crohn's disease. Intravenous steroids, administered in a hospital setting, are used when oral steroids do not work or cannot be taken. Because corticosteroids reduce the body's ability to fight infection, care must be taken to ensure that there is no active infection, particularly an intra-abdominal 481:) to treat Crohn's disease in 2014. It is indicated for management of moderate-to-severe, active Crohn's disease patients and it works by inhibiting the trafficking of pro-inflammatory immune cells to the site of inflammation. Evidence from three randomized control trials, including an international, multi-center, randomized, parallel-group, double-blind clinical trial, 230: 382:, like infliximab, is an antibody that targets tumor necrosis factor. It has been shown to reduce the signs and symptoms of, and is approved for treatment of, moderate to severe Crohn's disease in adults who have not responded well to conventional treatments and who have lost response to or are unable to tolerate infliximab. 198:, meaning that lower quantities of the drug enter the bloodstream. It has been shown to be useful in the treatment of mild to moderate Crohn's disease, and in maintaining remission. It is also effective when used in combination with antibiotics to treat active Crohn's disease. Budesonide is released in the 739:

is an ayurvedic (Indian traditional medicine) herb, used as a natural alternative to drugs. One study has found that the effectiveness of H-15 extract is not inferior to mesalazine: "Considering both safety and efficacy of Boswellia serrata extract H15, it appears to be superior over mesalazine in

1264:

Sandborn, William J.; Lofberg, Robert; Feagan, Brian G.; Hanauer, Stephen B.; Campieri, Massimo; Greenberg, Gordon R. (2005). "Budesonide for Maintenance of Remission in Patients with Crohn's Disease in Medically Induced Remission: A Predetermined Pooled Analysis of Four Randomized, Double-Blind,

441:

Also associated with a rare but serious risk of multifocal leukoencephalopathy (brain infection leading to death or severe disability). Therefore, a specific program exists in which prescribers must be enrolled, CD-TOUCH (Crohn's Disease-Tysabri Outreach Unified Commitment to Health) Prescribing

385:

Adalimumab also has a number of serious, potentially fatal, safety concerns characteristic of the anti-TNFα drugs. It, too, has a black-box warning on its FDA label. Listed potential side effects include serious and sometimes fatal blood disorders; serious infections including tuberculosis and

92:

Once remission is induced, the goal of treatment becomes maintenance of remission: avoiding the return of active disease, or "flares". Because of side effects, the prolonged use of corticosteroids is avoided. Although some people are able to maintain remission spontaneously, many require

465:

suggest that ustekinumab is effective for induction of clinical remission and clinical improvement in patients with moderate to severe Crohn's disease. Based on these studies, ustekinumab appears to be safe, but the implications of longer-term drug administration needs to be studied.

2900:

Schreiber, Stefan; Rutgeerts, Paul; Fedorak, Richard N.; Khaliq–Kareemi, Munaa; Kamm, Michael A.; Boivin, Michel; Bernstein, Charles N.; Staun, Michael; et al. (2005). "A Randomized, Placebo-Controlled Trial of Certolizumab Pegol (CDP870) for Treatment of Crohn's Disease".

643:

programs. Smoking can not only make Crohn's disease worse in people who do it, but also increase the risk of recurrence after surgery. If a Crohn's disease patient who undergoes surgery does not quit smoking, the disease is likely to recur more aggressively.

89:, or if the disease does not respond to drugs within a reasonable time. However, surgery cannot cure Crohn's disease. It involves removing the diseased part of the intestine and rejoining the healthy ends, but the disease tends to recur after surgery. 1570:

Hanauer, Stephen B; Feagan, Brian G; Lichtenstein, Gary R; Mayer, Lloyd F; Schreiber, S; Colombel, Jean Frederic; Rachmilewitz, Daniel; Wolf, Douglas C; et al. (2002). "Maintenance infliximab for Crohn's disease: The ACCENT I randomised trial".

281:

Azathioprine treatment may lead to rare but life-threatening side effects. The rare side effects include leukopenia or pancreatitis. There may also be an increased risk of lymphoma that is associated with azathioprine or 6-mercaptopurine treatment.

2565:

Joos, Stefanie; Brinkhaus, Benno; Maluche, Christa; Maupai, Nathalie; Kohnen, Ralf; Kraehmer, Nils; Hahn, Eckhart G.; Schuppan, Detlef (2004). "Acupuncture and Moxibustion in the Treatment of Active Crohn's Disease: A Randomized Controlled Study".

567:

usually requires adjustments by patients; if a patient finds that certain foods increase or decrease symptoms, they may adjust their diet accordingly. A food diary is recommended to see what positive or negative effects particular foods have. A

505:

Surgery is normally reserved for complications of Crohn's disease or when disease that resists treatment with drugs is confined to one location that can be removed. Surgery is often used to manage complications of Crohn's disease, including

538:). None of these surgeries cure or eliminate Crohn's disease, as the disease eventually comes back in healthy segments of the intestine, although when Crohn's disease recurs after surgery, it usually comes back at the site of the surgery. 777:

may be used to treat Crohn's disease with colonic or perianal involvement, although this usage has not been approved by the Food and Drug Administration. They are also used to treat complications, including abscesses and other

1099:

Feuerstein, Joseph D.; Ho, Edith Y.; Shmidt, Eugenia; Singh, Harminder; Falck-Ytter, Yngve; Sultan, Shanaz; Terdiman, Jonathan P.; American Gastroenterological Association Institute Clinical Guidelines Committee (June 2021).

2609:

Gerhardt, H; Seifert, F; Buvari, P; Vogelsang, H; Repges, R (2001). "Therapie des aktiven Morbus Crohn mit dem Boswellia-serrata-Extrakt H 15" [Therapy of active Crohn disease with Boswellia serrata extract H 15].

2875: 113:, have shown to be of very little efficacy in the treatment of Crohn's disease, either for induction or for maintenance of remission. Current guidelines do not advise the use of 5-ASA compounds in Crohn's disease. 416:

monoclonal antibody that has shown utility as induction and maintenance treatment for moderate to severe Crohn's disease. Natalizumab may be appropriate in patients who do not respond to medications that block

1870:

Michetti, Pierre; Mottet, Christian; Juillerat, Pascal; Pittet, Valérie; Felley, Christian; Vader, John-Paul; Gonvers, Jean-Jacques; Froehlich, Florian (2007). "Severe and Steroid-Resistant Crohn's Disease".

794:

may be used to treat Crohn's disease because of its anti-inflammatory properties. Cannabis and cannabis-derived drugs may also help to heal the gut lining, and may reduce the need for surgery and other

258:

A Cochrane systematic review that included 13 randomized controlled trials, concluded that azathioprine and 6-mercaptopurine are not effective for inducing remission when a person has Crohn's disease.

727:, improving quality of life, general well-being and a small decrease in blood-bound inflammatory markers. This study however had a very small test set and did not reach the threshold for benefit. 2136: 1980:

Feagan, Brian G.; Sandborn, William J.; Hass, Steven; Niecko, Timothy; White, Jeffrey (2007). "Health-Related Quality of Life During Natalizumab Maintenance Therapy for Crohn's Disease".

136:

are a class of anti-inflammatory drugs used to treat moderate to severe flares of Crohn's disease. However, they are used sparingly because they can cause serious side effects, including

265:

Maintenance therapy with azathioprine or 6-mercaptopurine may lead people with active Crohn's to take less steroid medication. This may lower side effects related to steroid treatments.

277:

A combination of azathioprine and infliximab treatment may be more effective than a single dose of infliximab to induce steroid-free remission for people with active Crohn's disease.

957:, a very inexpensive drug, helped patients with active Crohn's disease. In the study, 89% of patients exhibited a response to therapy, and 67% achieved remission within four weeks. 810:, can cause flares of inflammatory bowel disease in approximately 25% of patients. These flares tend to occur within one week after starting regular use of the NSAID. In contrast, 325:

that inhibits the pro-inflammatory cytokine TNFα. It is administered intravenously and dosed per weight starting at 5 mg/kg and increasing according to character of disease.

1634:

Sands, Bruce E.; Anderson, Frank H.; Bernstein, Charles N.; Chey, William Y.; Feagan, Brian G.; Fedorak, Richard N.; Kamm, Michael A.; Korzenik, Joshua R.; et al. (2004).

1815:

Sandborn, William J.; Colombel, Jean Frédéric; Enns, Roberts; Feagan, Brian G.; Hanauer, Stephen B.; Lawrance, Ian C.; Panaccione, Remo; Sanders, Martin; et al. (2005).

534:

and anastomosis – the removal of the affected section of intestine and the rejoining of the healthy sections – is the surgery usually performed for Crohn's disease (e.g.,

3187:

Smith, Jill P.; Stock, Heather; Bingaman, Sandra; Mauger, David; Rogosnitzky, Moshe; Zagon, Ian S. (2007). "Low-Dose Naltrexone Therapy Improves Active Crohn's Disease".

664:

were available in 2020, with no clear overall evidence of higher remission nor lower adverse effects, in people with Crohn's disease receiving probiotic supplementation.

1746:

Hanauer, Stephen B.; Sandborn, William J.; Rutgeerts, Paul; Fedorak, Richard N.; Lukas, Milan; MacIntosh, Donald; Panaccione, Remo; Wolf, Douglas; Pollack, Paul (2006).

1001:

Hanauer, Stephen B.; Sandborn, William; Practice Parameters Committee of the American College of Gastroenterology (2001). "Management of Crohn's disease in adults".

2702:

Feagan, Brian G.; Fedorak, Richard N.; Irvine, E. Jan; Wild, Gary; Sutherland, Lloyd; Steinhart, A. Hillary; Greenberg, Gordon R.; Koval, John; et al. (2000).

1939:

Ghosh, Subrata; Goldin, Eran; Gordon, Fiona H.; Malchow, Helmut A.; Rask-Madsen, Jørgen; Rutgeerts, Paul; Vyhnálek, Petr; Zádorová, Zdena; et al. (2003).

3079: 1223:

Greenberg, Gordon R.; Feagan, Brian G.; Martin, Francois; Sutherland, Lloyd R.; Thomson, Alan; Williams, C. Noel; Nilsson, Lars-Goran; Persson, Tore (1994).

1036: 255:. They have a duration of action of months (slow-acting). Both drugs are dosed at 1.5 to 2.5 mg/kg, with literature supporting the use of higher doses. 3247: 680:

infections have been demonstrated to have beneficial effects on hosts who have diseases linked to overactive immune systems. This may be explained by the

639:

Stress can influence the course of Crohn's disease. Smoking has also been associated with the disease, and smokers with Crohn's are encouraged to explore

3473: 3037:

Korzenik, Joshua R.; Dieckgraefe, Brian K.; Valentine, John F.; Hausman, Diana F.; Gilbert, Mark J.; Sargramostim in Crohn's Disease Study Group (2005).

2982:

Mannon, Peter J.; Fuss, Ivan J.; Mayer, Lloyd; Elson, Charles O.; Sandborn, William J.; Present, Daniel; Dolin, Ben; Goodman, Nancy; et al. (2004).

461:. Originally designed to treat psoriasis, ustekinumab was approved by the FDA for the treatment of Crohn's disease in 2016. Evidence from four quality 431:

have demonstrated that natalizumab is effective in increasing rates of remission and maintaining symptom-free status in patients with Crohn's disease.

3146:

Oyama, Yu; Craig, Robert M.; Traynor, Ann E.; Quigley, Kathleen; Statkute, Laisvyde; Halverson, Amy; Brush, Mary; Verda, Larissa; et al. (2005).

563:

Many diets have been proposed for the management of Crohn's disease, and many do improve symptoms, but none have been proven to cure the disease. The

3286: 967: 3504: 3499: 2792:

Cohen, LB (2004). "Re: Disappearance of Crohn's ulcers in the terminal ileum after thalidomide therapy. Can J Gastroenterol 2004; 18(2): 101-104".

2327: 424:

In January 2008, the FDA approved natalizumab for both induction of remission and maintenance of remission for moderate to severe Crohn's disease.

1501:

Hanauer, Stephen B.; Korelitz, Burton I.; Rutgeerts, Paul; Peppercorn, Mark A.; Thisted, Ronald A.; Cohen, Russell D.; Present, Daniel H. (2004).

3023: 2936: 1856: 943: 2753:"A comparative study of metronidazole and sulfasalazine for active Crohn's disease: The cooperative Crohn's disease study in Sweden. II. Result" 3463: 2844:

Naftali, T; Lev, LB; Yablecovitch, D; Half, E; Konikoff, FM (2011). "Treatment of Crohn's disease with cannabis: An observational study".

879: 2137:"FDA Approves STELARA® (Ustekinumab) for Treatment of Adults With Moderately to Severely Active Crohn's Disease | Johnson & Johnson" 660:

has been researched recently to understand whether it may help to improve remission rate in people with Crohn's disease. However only 2

2105: 3240: 1102:"AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn's Disease" 2025:"Progressive Multifocal Leukoencephalopathy Complicating Treatment with Natalizumab and Interferon Beta-1a for Multiple Sclerosis" 489:), demonstrated that Vedolizumab is effective for induction and maintenance of remission in patients with active Crohn's disease. 477:

is a gut-selective, Alpha-4 Beta-7 anti-integrin, monoclonal antibody that was approved by the U.S. Food and Drug Administration (

3509: 2819: 826:, also appears to be safe, at least in short-term studies of patients in remission and on medication for their Crohn's disease. 3225: 2350: 1308:

Steinhart, A; Feagan, BG; Wong, CJ; Vandervoort, M; Mikolainis, S; Croitoru, K; Seidman, E; Leddin, DJ; et al. (2002).

3483: 2887: 925: 799: 3233: 2751:

Ursing, B; Alm, T; Bárány, F; Bergelin, I; Ganrot-Norlin, K; Hoevels, J; Huitfeldt, B; Järnerot, G; et al. (1982).

1000: 908:

for the treatment of multiple autoimmune diseases, including Crohn's disease. Phase II trials showed promising results,

1503:"Postoperative maintenance of Crohn's disease remission with 6-mercaptopurine, mesalamine, or placebo: A 2-year trial" 3278: 982: 947: 696:

More than half of people with Crohn's disease have tried complementary or alternative therapy. These include diets,

2513:

Caprilli, R; Gassull, MA; Escher, JC; Moser, G; Munkholm, P; Forbes, A; Hommes, DW; Lochs, H; et al. (2006).

65:, it cannot be cured by medication or surgery. Treatment initially involves the use of medications to eliminate 3468: 2366:

Belluzzi, Andrea; Brignola, Corrado; Campieri, Massimo; Pera, Angelo; Boschi, Stefano; Miglioli, Mario (1996).

857:

have been recently completed or are ongoing for new therapies for Crohn's disease. They include the following:

2950: 1541: 3478: 905: 191: 2964: 1918: 1748:"Human Anti–Tumor Necrosis Factor Monoclonal Antibody (Adalimumab) in Crohn's Disease: The CLASSIC-I Trial" 478: 286: 3530: 2515:"European evidence based consensus on the diagnosis and management of Crohn's disease: Special situations" 438:). The label also recommends monitoring of liver enzymes due to concerns over possible damage or failure. 247:(6-MP) are the most commonly used immunosuppressants for maintenance therapy of Crohn's disease. They are 3535: 462: 428: 418: 314: 3402: 3354: 3256: 564: 1543: 1310:"Combined budesonide and antibiotic therapy for active Crohn's disease: A randomized controlled trial" 2655:"An old herbal medicine with a potentially new therapeutic application in inflammatory bowel disease" 2407:

Limketkai, Berkeley N.; Akobeng, Anthony K.; Gordon, Morris; Adepoju, Akinlolu Adedayo (2020-07-17).

541: 2064:

Langer-Gould, Annette; Atlas, Scott W.; Green, Ari J.; Bollen, Andrew W.; Pelletier, Daniel (2005).

2466:"A proof of concept study establishing Necator americanus in Crohn's patients and reservoir donors" 1361:

Chande, Nilesh; Townsend, Cassandra M; Parker, Claire E; MacDonald, John K; Chande, Nilesh (2016).

685: 608:

deficiency and may need supplementation. In cases with extensive small intestine involvement, the

3148:"Autologous hematopoietic stem cell transplantation in patients with refractory Crohn's disease" 3412: 3255: 2704:"A Comparison of Methotrexate with Placebo for the Maintenance of Remission in Crohn's Disease" 946:, which may be a cause of Crohn's disease. This treatment, called Myoconda, is being tested by 519: 398: 340: 94: 1620: 3417: 3017: 2930: 2321: 1850: 1608: 1030: 976: 704:

and nutritional supplements. The benefit, if any, and risks of these therapies is uncertain.

549: 530:(expansion of the stricture) is sometimes performed. Otherwise, and for other complications, 137: 78: 386:

infections caused by viruses, fungi, or bacteria; rare reports of lymphoma and solid tissue

3369: 3359: 871:

fragment of a humanized anti-TNFα monoclonal antibody that was found to have efficacy over

581: 552: 545: 54: 3407: 8: 1914: 1794: 1185:

Hanauer, SB (1991). "Sulfasalazine vs. Steroids in Crohn's disease: David vs. Goliath?".

954: 901: 865: 573: 531: 322: 251:

anti-metabolites, meaning that they interfere with the synthesis of purines required for

1454:"Antibiotics and azathioprine for the treatment of perianal fistulas in Crohn's disease" 1452:

Dejaco, C.; Harrer, M.; Waldhoer, T.; Miehsler, W.; Vogelsang, H.; Reinisch, W. (2003).

3443: 3264: 3260: 3212: 3123: 3098: 2733: 2679: 2654: 2635: 2591: 2539: 2514: 2490: 2465: 2464:

Croese, J; O'Neil, J; Masson, J; Cooke, S; Melrose, W; Pritchard, D; Speare, R (2006).

2441: 2408: 2309: 2195: 2162: 2005: 1896: 1706: 1596: 1483: 1410: 1387: 1362: 1290: 1134: 1101: 1076: 1051: 861: 723:. Evidence has been put forth suggesting that acupuncture can have benefits beyond the 681: 673: 435: 364: 161: 62: 58: 2769: 2752: 2219: 2161:

MacDonald, John K.; Nguyen, Tran M.; Khanna, Reena; Timmer, Antje (25 November 2016).

2112: 1584: 1414: 1014: 766:. It is useful in maintenance of remission for those no longer taking corticosteroids. 593:

Because the terminal ileum is the most common site of involvement and is the site for

482: 293:. However, it confers considerably less morbidity and mortality than corticosteroids. 3374: 3314: 3204: 3200: 3169: 3128: 3080:"Improving Mucosal Barrier Function—A Novel Therapeutic Strategy for Crohn's Disease" 3060: 3005: 2918: 2853: 2823: 2820:""Cannabis-based drugs could offer new hope for inflammatory bowel disease patients"" 2801: 2774: 2725: 2684: 2666: 2653:

Li, Richard; Alex, Philip; Ye, Mei; Zhang, Ting; Liu, Ling; Li, Xuhang (2011-10-29).

2639: 2627: 2583: 2544: 2495: 2446: 2428: 2389: 2346: 2301: 2296: 2279: 2239: 2200: 2182: 2087: 2046: 1997: 1993: 1962: 1888: 1838: 1769: 1698: 1693: 1676: 1657: 1588: 1524: 1475: 1470: 1453: 1434: 1392: 1331: 1282: 1278: 1246: 1202: 1198: 1139: 1121: 1081: 1018: 661: 640: 629: 511: 344: 310: 195: 24: 2737: 1900: 1710: 1677:"Review article: Infliximab therapy for inflammatory bowel disease - seven years on" 1542:

National Toxicology Program, United States Department of Health and Human Services.

1487: 1294: 3319: 3216: 3196: 3159: 3118: 3110: 3050: 2995: 2910: 2764: 2715: 2674: 2619: 2595: 2575: 2534: 2526: 2485: 2477: 2436: 2424: 2420: 2379: 2313: 2291: 2231: 2190: 2178: 2174: 2077: 2036: 2009: 1989: 1952: 1880: 1828: 1759: 1688: 1647: 1600: 1580: 1514: 1465: 1426: 1382: 1378: 1374: 1321: 1274: 1236: 1194: 1129: 1113: 1071: 1067: 1063: 1010: 922:

is a pig whipworm that been shown in one study to improve Crohn's disease symptoms.

791: 569: 434:

Natalizumab has also been linked to PML (though only when used in combination with

348: 244: 169: 2066:"Progressive Multifocal Leukoencephalopathy in a Patient Treated with Natalizumab" 1787: 1724: 3164: 3147: 2914: 2368:"Effect of an Enteric-Coated Fish-Oil Preparation on Relapses in Crohn's Disease" 2277: 1764: 1747: 1519: 1502: 1117: 886:

chemokine receptor antagonist intended to modulate immune response. It failed in

854: 823: 527: 203: 50: 2720: 2703: 2384: 2367: 2235: 1363:"Azathioprine or 6-mercaptopurine for induction of remission in Crohn's disease" 1241: 1224: 887: 3309: 972: 935: 897: 834: 724: 594: 486: 458: 454: 360: 236:, shown here in tablet form, is a first line steroid-sparing immunosuppressant. 218: 133: 82: 544:

are becoming less experimental, but are still mainly performed in response to

3524: 3422: 3344: 2670: 2530: 2432: 2257: 2186: 1125: 811: 774: 770: 743: 720: 609: 395: 110: 85:). Surgery may be required for complications such as obstructions, fistulae, 3114: 3097:

Summers, R W; Elliott, DE; Urban Jr, JF; Thompson, R; Weinstock, JV (2005).

2481: 1326: 1309: 1163: 1052:"Aminosalicylates for induction of remission or response in Crohn's disease" 656:

supplements to modify the composition and behaviour of the gastrointestinal

3438: 3364: 3208: 3173: 3132: 3064: 3009: 2922: 2857: 2805: 2729: 2688: 2631: 2587: 2548: 2499: 2450: 2305: 2204: 2163:"Anti-IL-12/23p40 antibodies for induction of remission in Crohn's disease" 2091: 2050: 2001: 1966: 1892: 1842: 1773: 1702: 1661: 1592: 1528: 1479: 1438: 1396: 1335: 1286: 1143: 1085: 1022: 911: 763: 755: 688:. Due to the unconventional nature of this therapy, it is not widely used. 633: 515: 356: 343:

class, can be serious and potentially fatal, and infliximab carries an FDA

240: 233: 157: 149: 74: 2778: 2393: 2243: 1250: 1206: 36: 3055: 3038: 3000: 2983: 2623: 2082: 2065: 2041: 2024: 1957: 1940: 1833: 1816: 1652: 1635: 1430: 939: 781: 712: 590:

may be effective in reducing the chance of relapse in less severe cases.

474: 450: 409: 2899: 1162:

Gopal, Latha; Nachimuthu, Senthil (June 16, 2011). Katz, Julian (ed.).

849:

or pig whipworm has been investigated for treatment of Crohn's disease.

697: 657: 621: 572:

may be used to reduce the volume of stools excreted daily. People with

379: 306: 290: 187: 176: 106: 70: 2579: 1884: 332:

Induction and maintenance of remission for people with Crohn's disease

3349: 3329: 931: 819: 803: 785: 736: 701: 653: 625: 617: 535: 252: 221:

and budesonide liquid and foam enemas are marketed for this purpose.

165: 66: 3379: 3036: 1817:"Natalizumab Induction and Maintenance Therapy for Crohn's Disease" 918: 868: 842: 807: 677: 587: 523: 413: 368: 318: 261:

Azathioprine and 6-MP may be useful for the following indications:

206:, and therefore has a topical effect against disease in that area. 145: 2280:"Intestinal transplantation: Current status and future directions" 1915:"FDA Approves Tysabri to Treat Moderate-to-Severe Crohn's Disease" 1500: 3339: 3324: 872: 815: 613: 577: 507: 352: 339:

Side effects of infliximab, like other immunosuppressants of the

268: 180: 153: 86: 1636:"Infliximab Maintenance Therapy for Fistulizing Crohn's Disease" 497: 1745: 1222: 759: 453:(CNTO 1275) is a monoclonal antibody that suppresses cytokines 387: 248: 214: 3096: 2608: 1569: 1307: 3334: 2406: 1869: 1360: 716: 391: 210: 199: 141: 126: 2365: 2063: 1451: 1263: 121: 2659:

International Journal of Clinical and Experimental Medicine

2463: 2160: 2022: 883: 229: 2965:"GSK's Crohn's disease treatment fails in Phase III trial" 2843: 2564: 2512: 2409:"Probiotics for induction of remission in Crohn's disease" 2343:

Breaking the Vicious Cycle: Intestinal Health Through Diet

2278:

Garg M., Jones R. M., Vaughan R. B., Testro A. G. (2011).

1814: 1633: 684:. Hookworm therapy is currently in the trial stage at the 636:

who do not simultaneously receive folate supplementation.

274:

Maintenance of remission after surgery for Crohn's disease

213:

can also be used to treat symptoms in the lower colon and

2984:"Anti–Interleukin-12 Antibody for Active Crohn's Disease" 1544:"Azathioprine. Report on Carcinogens, Fourteenth Edition" 602:

absorption, people with Crohn's disease are at risk for B

224: 3186: 3145: 2023:

Kleinschmidt-Demasters, B.K.; Tyler, Kenneth L. (2005).

1979: 1938: 580:-containing foods. Patients who cannot eat may be given 2750: 2701: 2260:. Crohn's and Colitis Foundation of America. March 2006 1674: 1098: 576:

due to small bowel disease may benefit from avoiding

309:(trade name Remicade, among others) is a mouse-human 129:

can be used for treatment of rectal disease symptoms.

2981: 1356: 1354: 1352: 1350: 1348: 1346: 1727:. The American Society of Health-System Pharmacists 168:. Corticosteroids should not be confused with the 2271: 2218:Wood, Alastair J.J.; Hanauer, Stephen B. (1996). 1343: 1035:: CS1 maint: DOI inactive as of September 2024 ( 968:Biological therapy for inflammatory bowel disease 3522: 3505:List of people diagnosed with ulcerative colitis 3474:National Society for Colitis and Crohn's Disease 2876:What should patients with Crohn's disease avoid? 1675:Rutgeerts, P.; Assche, G.; Vermeire, S. (2006). 401:disorders; and rare reports of cardiac failure. 1161: 715:is used to treat inflammatory bowel disease in 1043: 3500:List of people diagnosed with Crohn's disease 3241: 2652: 2098: 175:The most commonly prescribed oral steroid is 2326:: CS1 maint: multiple names: authors list ( 2250: 1932: 1225:"Oral Budesonide for Active Crohn's Disease" 285:Azathioprine is listed by the United States 3099:"Trichuris suis therapy in Crohn's disease" 3084:US Gastroenterology & Hepatology Review 3077: 3022:: CS1 maint: numeric names: authors list ( 2935:: CS1 maint: numeric names: authors list ( 2413:The Cochrane Database of Systematic Reviews 2217: 2211: 2167:The Cochrane Database of Systematic Reviews 1855:: CS1 maint: numeric names: authors list ( 944:mycobacterium avium subsp. paratuberculosis 762:anti-metabolite drug that is also used for 584:(TPN), a source of vitamins and nutrients. 335:Maintenance for fistulizing Crohn's disease 3248: 3234: 2457: 2340: 2284:Journal of Gastroenterology and Hepatology 994: 647: 347:on the label. Listed side effects include 53:symptoms of the disease, then maintaining 3464:Crohn's and Colitis Foundation of America 3163: 3122: 3054: 3039:"Sargramostim for Active Crohn's Disease" 2999: 2768: 2719: 2678: 2538: 2489: 2440: 2383: 2295: 2194: 2081: 2057: 2040: 2016: 1956: 1832: 1763: 1692: 1651: 1518: 1469: 1386: 1325: 1240: 1133: 1075: 328:Infliximab has found utility as follows: 3189:The American Journal of Gastroenterology 2871: 2869: 2867: 1982:The American Journal of Gastroenterology 1941:"Natalizumab for Active Crohn's Disease" 1717: 1681:Alimentary Pharmacology and Therapeutics 1458:Alimentary Pharmacology and Therapeutics 1409: 1403: 1267:The American Journal of Gastroenterology 1003:The American Journal of Gastroenterology 890:, showing no improvement over a placebo. 833: 496: 228: 120: 2560: 2558: 1563: 1367:Cochrane Database of Systematic Reviews 1218: 1216: 1184: 1056:Cochrane Database of Systematic Reviews 1049: 900:monoclonal antibody being developed by 719:, and is being used more frequently in 691: 3523: 2846:The Israel Medical Association Journal 1157: 1155: 1153: 321:in the inflammatory response. It is a 225:Mercaptopurine immunosuppressing drugs 172:used to enhance athletic performance. 3229: 2864: 2791: 800:Non-steroidal anti-inflammatory drugs 667: 558: 296: 183:, before the initiation of steroids. 3484:World Inflammatory Bowel Disease Day 2888:Beth Israel Deaconess Medical Center 2794:Canadian Journal of Gastroenterology 2555: 1213: 749: 740:terms of a benefit-risk-evaluation." 632:is a risk for patients treated with 355:reactions, risk of re-activation of 2106:"Tysabri product information sheet" 1150: 942:are antibiotics designed to attack 367:. Serious side effect also include 190:(trade name Entocort), has limited 100: 13: 2880:Inflammatory Bowel Disease Program 501:Resected ileum for Crohn's disease 116: 14: 3547: 2612:Zeitschrift für Gastroenterologie 1015:10.1111/j.1572-0241.2001.3671_c.x 983:Essential fatty acid interactions 19:Management of Crohn's disease 3201:10.1111/j.1572-0241.2007.01045.x 2297:10.1111/j.1440-1746.2011.06783.x 1994:10.1111/j.1572-0241.2007.01508.x 1694:10.1111/j.1365-2036.2006.02786.x 1471:10.1046/j.1365-2036.2003.01793.x 1279:10.1111/j.1572-0241.2005.41992.x 1050:Lim, Wee-Chian; Wang, Y (2016). 926:Autologous stem cell transplants 784:has shown efficacy in reversing 3180: 3139: 3090: 3071: 3043:New England Journal of Medicine 3030: 2988:New England Journal of Medicine 2975: 2957: 2943: 2893: 2837: 2812: 2785: 2744: 2708:New England Journal of Medicine 2695: 2646: 2602: 2506: 2400: 2372:New England Journal of Medicine 2359: 2334: 2224:New England Journal of Medicine 2154: 2129: 2070:New England Journal of Medicine 2029:New England Journal of Medicine 1973: 1945:New England Journal of Medicine 1907: 1863: 1821:New England Journal of Medicine 1808: 1780: 1739: 1668: 1640:New England Journal of Medicine 1627: 1535: 1494: 1445: 1419:New England Journal of Medicine 1229:New England Journal of Medicine 672:In an experimental idea called 3469:Digestive Disorders Foundation 3279:Crohn's Disease Activity Index 2425:10.1002/14651858.CD006634.pub3 2179:10.1002/14651858.CD007572.pub3 1379:10.1002/14651858.CD000545.pub5 1301: 1257: 1178: 1092: 1068:10.1002/14651858.CD008870.pub2 707: 469: 445: 404: 1: 3078:Dieckgraefe, Brian K (2006). 2951:"GSK IBD Drug Fails in Trial" 2770:10.1016/S0016-5085(82)80189-3 2258:"Surgery for Crohn's Disease" 1585:10.1016/S0140-6736(02)08512-4 988: 906:Cambridge Antibody Technology 374: 301: 186:Another oral corticosteroid, 47:Management of Crohn's disease 3165:10.1053/j.gastro.2004.11.051 2915:10.1053/j.gastro.2005.06.064 2800:(6): 419, author reply 419. 2345:. Baltimore: Kirkton Press. 2220:"Inflammatory Bowel Disease" 1919:Food and Drug Administration 1765:10.1053/j.gastro.2005.11.030 1520:10.1053/j.gastro.2004.06.002 1415:"Inflammatory Bowel Disease" 1265:Placebo-Controlled Trials". 1199:10.1016/0016-5085(91)90746-8 1118:10.1053/j.gastro.2021.04.022 429:randomized controlled trials 394:injury; and rare reports of 81:anti-inflammatory drugs and 49:involves first treating the 7: 3510:Deaths from Crohn's disease 2721:10.1056/NEJM200006013422202 2385:10.1056/NEJM199606133342401 2341:Gottschall, Elaine (1994). 2236:10.1056/NEJM199603283341307 1242:10.1056/NEJM199409293311303 961: 878:Traficet-EN/CCX282/GSK'786/ 829: 542:Small intestine transplants 419:tumor necrosis factor-alpha 315:tumor necrosis factor alpha 10: 3552: 3479:Crohn's and Colitis Canada 3403:Giovanni Battista Morgagni 3355:Protein losing enteropathy 3257:Inflammatory bowel disease 1788:"Medication guide: Humira" 582:total parenteral nutrition 565:specific carbohydrate diet 492: 390:; rare reports of serious 3492: 3456: 3431: 3395: 3388: 3302: 3271: 953:A pilot study found that 928:have also been evaluated. 888:Phase III clinical trials 730: 463:randomized control trials 105:5-ASA compounds, such as 33: 23: 18: 2884:Digestive Disease Center 2531:10.1136/gut.2005.081950c 686:University of Nottingham 3375:Small bowel obstruction 3115:10.1136/gut.2004.041749 2482:10.1136/gut.2005.079129 1758:(2): 323–33, quiz 591. 1327:10.1053/gast.2002.34225 1017:(inactive 2024-09-12). 648:Microbiome Modification 371:and severe infections. 95:immunosuppressive drugs 63:immune system condition 3413:Thomas Kennedy Dalziel 2890:. Retrieved March 2014 850: 548:due to a high rate of 520:small intestine cancer 502: 421:, such as infliximab. 399:central nervous system 237: 130: 3418:Burrill Bernard Crohn 977:Bile acid sequestrant 837: 700:, fish oil and other 536:ileocolonic resection 500: 232: 196:first-pass metabolism 124: 3370:Short bowel syndrome 3360:Pyoderma gangrenosum 3056:10.1056/NEJMoa041109 3001:10.1056/NEJMoa033402 2624:10.1055/s-2001-10708 2083:10.1056/NEJMoa051847 2042:10.1056/NEJMoa051782 1958:10.1056/NEJMoa020732 1834:10.1056/NEJMoa043335 1653:10.1056/NEJMoa030815 1431:10.1056/NEJMra020831 904:in conjunction with 788:evidence of disease. 692:Alternative medicine 546:short bowel syndrome 194:and a high level of 2525:(Suppl 1): i36–58. 2143:. 26 September 2016 1795:Abbott Laboratories 1411:Podolsky, Daniel K. 955:Low-dose naltrexone 902:Abbott Laboratories 875:in one large trial. 818:appear to be safe. 574:lactose intolerance 427:A total of 3 large 323:monoclonal antibody 3536:Medical treatments 3444:William Hale-White 3287:Biological therapy 3265:ulcerative colitis 2118:on August 22, 2007 1619:has generic name ( 1464:(11–12): 1113–20. 851: 814:(paracetamol) and 802:(NSAIDs), such as 682:hygiene hypothesis 674:helminthic therapy 668:Helminthic therapy 628:may be deficient. 559:Diet and lifestyle 522:and fibrostenotic 503: 436:interferon beta-1a 365:multiple sclerosis 297:Biologic therapies 253:inflammatory cells 238: 162:avascular necrosis 138:Cushing's syndrome 131: 3518: 3517: 3452: 3451: 3408:Antoni Leśniowski 2580:10.1159/000078151 2352:978-0-9692768-1-4 1885:10.1159/000111023 1551:ntp.niehs.nih.gov 750:Other medications 662:controlled trials 641:smoking cessation 630:Folate deficiency 606: 599: 512:bowel obstruction 345:black-box warning 311:chimeric antibody 170:anabolic steroids 44: 43: 3543: 3393: 3392: 3320:Erythema nodosum 3250: 3243: 3236: 3227: 3226: 3221: 3220: 3184: 3178: 3177: 3167: 3152:Gastroenterology 3143: 3137: 3136: 3126: 3094: 3088: 3087: 3075: 3069: 3068: 3058: 3049:(21): 2193–201. 3034: 3028: 3027: 3021: 3013: 3003: 2979: 2973: 2972: 2961: 2955: 2954: 2947: 2941: 2940: 2934: 2926: 2903:Gastroenterology 2897: 2891: 2873: 2862: 2861: 2841: 2835: 2834: 2832: 2831: 2822:. Archived from 2816: 2810: 2809: 2789: 2783: 2782: 2772: 2757:Gastroenterology 2748: 2742: 2741: 2723: 2699: 2693: 2692: 2682: 2650: 2644: 2643: 2606: 2600: 2599: 2562: 2553: 2552: 2542: 2510: 2504: 2503: 2493: 2461: 2455: 2454: 2444: 2404: 2398: 2397: 2387: 2363: 2357: 2356: 2338: 2332: 2331: 2325: 2317: 2299: 2290:(8): 1221–1228. 2275: 2269: 2268: 2266: 2265: 2254: 2248: 2247: 2215: 2209: 2208: 2198: 2173:(11): CD007572. 2158: 2152: 2151: 2149: 2148: 2133: 2127: 2126: 2124: 2123: 2117: 2111:. Archived from 2110: 2102: 2096: 2095: 2085: 2061: 2055: 2054: 2044: 2020: 2014: 2013: 1977: 1971: 1970: 1960: 1936: 1930: 1929: 1927: 1926: 1911: 1905: 1904: 1867: 1861: 1860: 1854: 1846: 1836: 1812: 1806: 1805: 1803: 1802: 1792: 1784: 1778: 1777: 1767: 1752:Gastroenterology 1743: 1737: 1736: 1734: 1732: 1721: 1715: 1714: 1696: 1672: 1666: 1665: 1655: 1631: 1625: 1624: 1618: 1614: 1612: 1604: 1579:(9317): 1541–9. 1567: 1561: 1560: 1558: 1557: 1548: 1539: 1533: 1532: 1522: 1507:Gastroenterology 1498: 1492: 1491: 1473: 1449: 1443: 1442: 1407: 1401: 1400: 1390: 1373:(10): CD000545. 1358: 1341: 1339: 1329: 1314:Gastroenterology 1305: 1299: 1298: 1261: 1255: 1254: 1244: 1220: 1211: 1210: 1187:Gastroenterology 1182: 1176: 1175: 1173: 1171: 1159: 1148: 1147: 1137: 1112:(7): 2496–2508. 1106:Gastroenterology 1096: 1090: 1089: 1079: 1062:(12): CD008870. 1047: 1041: 1040: 1034: 1026: 998: 896:is a human anti- 769:The antibiotics 652:The use of oral 604: 597: 570:low residue diet 349:hypersensitivity 245:6-mercaptopurine 101:Aminosalicylates 37:edit on Wikidata 29:gastroenterology 16: 15: 3551: 3550: 3546: 3545: 3544: 3542: 3541: 3540: 3531:Crohn's disease 3521: 3520: 3519: 3514: 3488: 3448: 3427: 3384: 3298: 3292:Crohn's disease 3267: 3261:Crohn's disease 3254: 3224: 3185: 3181: 3144: 3140: 3095: 3091: 3076: 3072: 3035: 3031: 3015: 3014: 2994:(20): 2069–79. 2980: 2976: 2963: 2962: 2958: 2949: 2948: 2944: 2928: 2927: 2898: 2894: 2874: 2865: 2842: 2838: 2829: 2827: 2818: 2817: 2813: 2790: 2786: 2749: 2745: 2714:(22): 1627–32. 2700: 2696: 2651: 2647: 2607: 2603: 2563: 2556: 2511: 2507: 2462: 2458: 2419:(7): CD006634. 2405: 2401: 2378:(24): 1557–60. 2364: 2360: 2353: 2339: 2335: 2319: 2318: 2276: 2272: 2263: 2261: 2256: 2255: 2251: 2216: 2212: 2159: 2155: 2146: 2144: 2135: 2134: 2130: 2121: 2119: 2115: 2108: 2104: 2103: 2099: 2062: 2058: 2021: 2017: 1988:(12): 2737–46. 1978: 1974: 1937: 1933: 1924: 1922: 1913: 1912: 1908: 1868: 1864: 1848: 1847: 1827:(18): 1912–25. 1813: 1809: 1800: 1798: 1790: 1786: 1785: 1781: 1744: 1740: 1730: 1728: 1723: 1722: 1718: 1673: 1669: 1632: 1628: 1616: 1615: 1606: 1605: 1568: 1564: 1555: 1553: 1546: 1540: 1536: 1499: 1495: 1450: 1446: 1408: 1404: 1359: 1344: 1306: 1302: 1262: 1258: 1221: 1214: 1183: 1179: 1169: 1167: 1164:"Crohn Disease" 1160: 1151: 1097: 1093: 1048: 1044: 1028: 1027: 999: 995: 991: 964: 855:clinical trials 832: 824:cox-2 inhibitor 752: 733: 721:Western society 710: 694: 670: 650: 607: 600: 561: 528:strictureplasty 495: 472: 448: 407: 377: 304: 299: 227: 134:Corticosteroids 119: 117:Corticosteroids 103: 83:corticosteroids 79:aminosalicylate 59:Crohn's disease 40: 12: 11: 5: 3549: 3539: 3538: 3533: 3516: 3515: 3513: 3512: 3507: 3502: 3496: 3494: 3490: 3489: 3487: 3486: 3481: 3476: 3471: 3466: 3460: 3458: 3454: 3453: 3450: 3449: 3447: 3446: 3441: 3435: 3433: 3429: 3428: 3426: 3425: 3420: 3415: 3410: 3405: 3399: 3397: 3390: 3386: 3385: 3383: 3382: 3377: 3372: 3367: 3362: 3357: 3352: 3347: 3342: 3337: 3332: 3327: 3322: 3317: 3312: 3310:Abdominal pain 3306: 3304: 3300: 3299: 3297: 3296: 3295: 3294: 3289: 3281: 3275: 3273: 3269: 3268: 3253: 3252: 3245: 3238: 3230: 3223: 3222: 3179: 3138: 3089: 3070: 3029: 2974: 2956: 2942: 2892: 2863: 2836: 2811: 2784: 2743: 2694: 2665:(4): 309–319. 2645: 2601: 2554: 2505: 2456: 2399: 2358: 2351: 2333: 2270: 2249: 2210: 2153: 2128: 2097: 2056: 2015: 1972: 1931: 1906: 1862: 1807: 1779: 1738: 1716: 1667: 1626: 1617:|first12= 1562: 1534: 1493: 1444: 1402: 1342: 1300: 1256: 1235:(13): 836–41. 1212: 1177: 1149: 1091: 1042: 992: 990: 987: 986: 985: 980: 973:Cholestyramine 970: 963: 960: 959: 958: 951: 936:clarithromycin 929: 923: 919:Trichuris suis 915: 909: 891: 876: 847:Trichuris suis 840:Trichuris spp. 831: 828: 822:(Celebrex), a 797: 796: 789: 779: 767: 751: 748: 747: 746: 741: 732: 729: 725:placebo effect 709: 706: 693: 690: 669: 666: 649: 646: 603: 596: 560: 557: 494: 491: 471: 468: 447: 444: 406: 403: 376: 373: 363:, and risk of 361:serum sickness 337: 336: 333: 303: 300: 298: 295: 279: 278: 275: 272: 266: 226: 223: 219:Hydrocortisone 118: 115: 102: 99: 42: 41: 34: 31: 30: 27: 21: 20: 9: 6: 4: 3: 2: 3548: 3537: 3534: 3532: 3529: 3528: 3526: 3511: 3508: 3506: 3503: 3501: 3498: 3497: 3495: 3491: 3485: 3482: 3480: 3477: 3475: 3472: 3470: 3467: 3465: 3462: 3461: 3459: 3457:Organizations 3455: 3445: 3442: 3440: 3437: 3436: 3434: 3430: 3424: 3423:Leon Ginzburg 3421: 3419: 3416: 3414: 3411: 3409: 3406: 3404: 3401: 3400: 3398: 3394: 3391: 3387: 3381: 3378: 3376: 3373: 3371: 3368: 3366: 3363: 3361: 3358: 3356: 3353: 3351: 3348: 3346: 3345:Malabsorption 3343: 3341: 3338: 3336: 3333: 3331: 3328: 3326: 3323: 3321: 3318: 3316: 3313: 3311: 3308: 3307: 3305: 3303:Complications 3301: 3293: 3290: 3288: 3285: 3284: 3282: 3280: 3277: 3276: 3274: 3270: 3266: 3262: 3258: 3251: 3246: 3244: 3239: 3237: 3232: 3231: 3228: 3218: 3214: 3210: 3206: 3202: 3198: 3194: 3190: 3183: 3175: 3171: 3166: 3161: 3158:(3): 552–63. 3157: 3153: 3149: 3142: 3134: 3130: 3125: 3120: 3116: 3112: 3108: 3104: 3100: 3093: 3085: 3081: 3074: 3066: 3062: 3057: 3052: 3048: 3044: 3040: 3033: 3025: 3019: 3011: 3007: 3002: 2997: 2993: 2989: 2985: 2978: 2971:. 2013-08-23. 2970: 2966: 2960: 2953:. 2013-08-23. 2952: 2946: 2938: 2932: 2924: 2920: 2916: 2912: 2909:(3): 807–18. 2908: 2904: 2896: 2889: 2885: 2881: 2877: 2872: 2870: 2868: 2859: 2855: 2851: 2847: 2840: 2826:on 2010-01-12 2825: 2821: 2815: 2807: 2803: 2799: 2795: 2788: 2780: 2776: 2771: 2766: 2763:(3): 550–62. 2762: 2758: 2754: 2747: 2739: 2735: 2731: 2727: 2722: 2717: 2713: 2709: 2705: 2698: 2690: 2686: 2681: 2676: 2672: 2668: 2664: 2660: 2656: 2649: 2641: 2637: 2633: 2629: 2625: 2621: 2617: 2614:(in German). 2613: 2605: 2597: 2593: 2589: 2585: 2581: 2577: 2573: 2569: 2561: 2559: 2550: 2546: 2541: 2536: 2532: 2528: 2524: 2520: 2516: 2509: 2501: 2497: 2492: 2487: 2483: 2479: 2475: 2471: 2467: 2460: 2452: 2448: 2443: 2438: 2434: 2430: 2426: 2422: 2418: 2414: 2410: 2403: 2395: 2391: 2386: 2381: 2377: 2373: 2369: 2362: 2354: 2348: 2344: 2337: 2329: 2323: 2315: 2311: 2307: 2303: 2298: 2293: 2289: 2285: 2281: 2274: 2259: 2253: 2245: 2241: 2237: 2233: 2230:(13): 841–8. 2229: 2225: 2221: 2214: 2206: 2202: 2197: 2192: 2188: 2184: 2180: 2176: 2172: 2168: 2164: 2157: 2142: 2138: 2132: 2114: 2107: 2101: 2093: 2089: 2084: 2079: 2076:(4): 375–81. 2075: 2071: 2067: 2060: 2052: 2048: 2043: 2038: 2035:(4): 369–74. 2034: 2030: 2026: 2019: 2011: 2007: 2003: 1999: 1995: 1991: 1987: 1983: 1976: 1968: 1964: 1959: 1954: 1950: 1946: 1942: 1935: 1920: 1916: 1910: 1902: 1898: 1894: 1890: 1886: 1882: 1879:(2): 99–108. 1878: 1874: 1866: 1858: 1852: 1844: 1840: 1835: 1830: 1826: 1822: 1818: 1811: 1796: 1789: 1783: 1775: 1771: 1766: 1761: 1757: 1753: 1749: 1742: 1726: 1720: 1712: 1708: 1704: 1700: 1695: 1690: 1687:(4): 451–63. 1686: 1682: 1678: 1671: 1663: 1659: 1654: 1649: 1646:(9): 876–85. 1645: 1641: 1637: 1630: 1622: 1610: 1602: 1598: 1594: 1590: 1586: 1582: 1578: 1574: 1566: 1552: 1545: 1538: 1530: 1526: 1521: 1516: 1512: 1508: 1504: 1497: 1489: 1485: 1481: 1477: 1472: 1467: 1463: 1459: 1455: 1448: 1440: 1436: 1432: 1428: 1425:(6): 417–29. 1424: 1420: 1416: 1412: 1406: 1398: 1394: 1389: 1384: 1380: 1376: 1372: 1368: 1364: 1357: 1355: 1353: 1351: 1349: 1347: 1337: 1333: 1328: 1323: 1319: 1315: 1311: 1304: 1296: 1292: 1288: 1284: 1280: 1276: 1273:(8): 1780–7. 1272: 1268: 1260: 1252: 1248: 1243: 1238: 1234: 1230: 1226: 1219: 1217: 1208: 1204: 1200: 1196: 1193:(4): 1130–1. 1192: 1188: 1181: 1165: 1158: 1156: 1154: 1145: 1141: 1136: 1131: 1127: 1123: 1119: 1115: 1111: 1107: 1103: 1095: 1087: 1083: 1078: 1073: 1069: 1065: 1061: 1057: 1053: 1046: 1038: 1032: 1024: 1020: 1016: 1012: 1009:(3): 635–43. 1008: 1004: 997: 993: 984: 981: 978: 974: 971: 969: 966: 965: 956: 952: 949: 945: 941: 937: 933: 930: 927: 924: 921: 920: 916: 913: 910: 907: 903: 899: 895: 892: 889: 885: 881: 877: 874: 870: 867: 863: 860: 859: 858: 856: 848: 844: 841: 836: 827: 825: 821: 817: 813: 812:acetaminophen 809: 805: 801: 793: 790: 787: 783: 780: 776: 775:ciprofloxacin 772: 771:Metronidazole 768: 765: 761: 757: 754: 753: 745: 744:Yunnan Baiyao 742: 738: 735: 734: 728: 726: 722: 718: 714: 705: 703: 699: 689: 687: 683: 679: 675: 665: 663: 659: 655: 645: 642: 637: 635: 631: 627: 623: 619: 615: 611: 601: 591: 589: 585: 583: 579: 575: 571: 566: 556: 554: 551: 547: 543: 539: 537: 533: 529: 525: 521: 517: 513: 509: 499: 490: 488: 484: 480: 476: 467: 464: 460: 456: 452: 443: 439: 437: 432: 430: 425: 422: 420: 415: 411: 402: 400: 397: 396:demyelinating 393: 389: 383: 381: 372: 370: 366: 362: 358: 354: 350: 346: 342: 334: 331: 330: 329: 326: 324: 320: 316: 313:that targets 312: 308: 294: 292: 288: 283: 276: 273: 270: 267: 264: 263: 262: 259: 256: 254: 250: 246: 242: 235: 231: 222: 220: 216: 212: 207: 205: 201: 197: 193: 189: 184: 182: 178: 173: 171: 167: 163: 159: 155: 152:, high blood 151: 147: 143: 139: 135: 128: 123: 114: 112: 111:sulfasalazine 108: 98: 96: 90: 88: 84: 80: 76: 73:) and reduce 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