Medical therapy for Crohn's disease.

The past year's literature pertaining to the medical treatment of Crohn's disease was highlighted by the US Food and Drug Administration's approval of infliximab. Other developments of interest include more evolutionary (in contrast to revolutionary) clinical data regarding aminosalicylates, antibiotics, and steroids as inductive agents and use of immunomodulatory agents as maintenance therapies. Comparative trials continue to demonstrate that steroids, including budesonide, have a greater acute benefit than aminosalicylates, but this benefit does not translate into long-term efficacy. Azathioprine and 6-mercaptopurine are the standard maintenance therapies for steroid-dependent Crohn's disease, and long-term safety data continue to accumulate regarding these agents in adults and children. Several novel approaches have been reported in preliminary fashion that will require much more extensive clinical experience and controlled-trial evidence.