Lege Artis Medicinae

[ANTI-TNF-α ANTIBODY THERAPY IN CROHN’S DISEASE]

LAKATOS Péter László1,2

SEPTEMBER 19, 2007

Lege Artis Medicinae - 2007;17(08-09)

[Crohn’s disease is a chronic inflammatory disorder which may affect any part of the gastrointestinal tract. Its pathogenesis is only partially understood; various environmental and host (e.g., genetic, epithelial, immune and nonimmune) factors are involved, together initiating a chronic uncontrolled inflammation, which is partly due to an imbalance between pro- and anti-inflammatory cytokines, and a defective apoptosis of lamina propria T cells. Among proinflammatory cytokines, tumour necrosis factor- α (TNF-α) seems to play a central role in Crohn’s disease. Over the past years, the increasing knowledge on the pathogenesis of Crohn’s disease has led to the development of a number of biological agents targeting specific molecules involved in gut inflammation, including TNF-α and its receptors. This paper reviews the rationale for the use of TNF-α inhibitors in the treatment of Crohn’s disease.]

AFFILIATIONS

  1. Semmelweis Egyetem, I. Sz. Belgyógyászati Klinika
  2. I. Sz. Belgyógyászati Osztály, Csolnoky Ferenc Megyei Kórház

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[ANTIHYPERTENSIVE THERAPY IN VIEW OF RECENT CLINICAL STUDIES]

ALFÖLDI Sándor

[Different antihypertensive agents, while having the same blood pressure lowering effect, will have significantly and clinically important different impact on the serum levels of glucose, lipids, insulin, potassium, creatinine, as well as on albumin excretion, heart rate, body weight, central pressure, various hypertensive target organ damages, and, in particular, 24-hour blood pressure dinamics. There is agreement in that the main benefits of first-line antihypertensive agents are related to the lowering of blood pressure itself. Some other drugs, however, have shown preventive and protective cardiovascular properties in certain patient groups, independent of their blood pressure lowering effect as measured traditionally.]

Lege Artis Medicinae

[Differences in the Prolonged Use of Drugs for Chronic Obstructive Pulmonary Disease]

BALIKÓ Zoltán

Lege Artis Medicinae

[BENEFICIAL EFFECT OF INSULIN DETEMIR ON THE BODY WEIGHT OF DIABETICS]

BECHER Péter

[Detemir is the newest base insulin analogue. In phase III trials and the PREDICTIVE study, the use of insulin detemir in various treatment regimens (basal-bolus or in combination with an oral antidiabetic) did not lead to weight gain in either types of diabetes, in contrast to what is usually observed with insulin therapy. Similar results were obtained when neutral protamine Hagedorn insulin or glargine were replaced by detemir, or insulin-naive patients received detemir as a new therapeutic regime. The mechanism of the beneficial effect on body weight is not clear yet. It may be related to the reduction in the number of hypoglycaemic episodes. It may also be associated with a stronger action of detemir on hepatocytes compared to peripheral tissues due to its acylation, which results in an effective suppression of hepatic glucose output without promoting lipogenesis in the adipocytes. Detemir reaches the insulin receptors of the hypothalamus faster than regular insulin, therefore, satiety develops in a shorter time. These hypotheses still require further studies.]

Lege Artis Medicinae

[INFLAMMATORY BOWEL DISEASE IN CHILDREN]

BODÁNSZKY Hedvig, VERES Gábor

[The term inflammatory bowel disease includes two similar, but distinct intestinal diseases so far of unknown ethiology - ulcerative colitis and Crohn’s disease. They used to be considered diseases of young adults, but in recent decades they have become more common among children, with characteristics different from those in adults. In the past they were considered severe, incurable diseases, but today, owing to modern nutrition, medical and surgical treatment, both diseases have became well manageable, even though complete recovery can not yet be expected.]

Lege Artis Medicinae

[Authorization and Marketing of Medicines in the European Union Member States]

BORVENDÉG János

All articles in the issue

Related contents

Clinical Neuroscience

Cholinesterase inhibitors and memantine for the treatment of Alzheimer and non-Alzheimer dementias

BALÁZS Nóra , BERECZKI Dániel, KOVÁCS Tibor

In aging societies, the morbidity and mortality of dementia is increasing at a significant rate, thereby imposing burden on healthcare, economy and the society as well. Patients’ and caregivers’ quality of life and life expectancy are greatly determined by the early diagnosis and the initiation of available symptomatic treatments. Cholinesterase inhibitors and memantine have been the cornerstones of Alzheimer’s therapy for approximately two decades and over the years, more and more experience has been gained on their use in non-Alzheimer’s dementias too. The aim of our work was to provide a comprehensive summary about the use of cholinesterase inhibitors and memantine for the treatment of Alzheimer’s and non-Alzheimers’s dementias.

Hypertension and nephrology

[Monitoring of the blood pressure lowering effectiveness of ramipril-amlodipine fix combination – a non-interventional trial (RAMONA study)]

TOMCSÁNYI János

[Purpose: Monitoring the effectiveness and safety of the fix combination formulation Egiramlon® therapy containing ramipril and amlodipin in patients, suffering from mild or moderate hypertension despite antihypertensive treatment. Patients and methods: Open, prospective, phase IV clinical observational study, which involved 9169 patients (age >18) with mild or moderate hypertension [TUKEB No: 16927- 1/2012/EKU (294/PI/12.)]. Ramipril/Amlodipin 5/5, 5/10, 10/5, 10/10 mg combinations were administered/ titrated in three visits, during the four months period according to the physician’s decision Blood pressure was measured by validated blood pressure sphygmomanometry and ABPM (Meditech, Hungary). The dosis of the fix combination formulation was determined individually during the visits by the 923 doctors involved in the study. The target blood pressure value was 140/90 mmHg, but in case of high risk patients population (diagnosed cardiovascular disease, diabetes), 130/90 mmHg target value was determined. Results: In 70.1% of the patients had no protocoll deviation. Patients data and examination results were processed according to this 6423 patient population. The average age of the patients were 60.2 year, in 50-50% sex distribution. The average duration of the treated hypertension was 9.8 years and the average blood pressure value was 157/91 mmHg. Till the end of the study, systolic blood pressure has decreased with 26.4 mmHg and diastolic pressure with 11.8 mmHg. An average 5.5 bpm heart rate frequency decreasing was observed at the end of the study. As a result of the treatment 52.4% of the patient population has reached the target blood pressure value.]

Hypertension and nephrology

[May measurement month: analysis of the Hungarian results of years 2017 and 2019]

NEMCSIK János, PÁLL Dénes, JÁRAI Zoltán

[Cardiovascular (CV) diseases are not only the leading causes of mortality in Hungary, but also the mortality rate is excessively high compared with the average of European Union, so screening programs identifying subjects with elevated blood pressure (BP) is of utmost importance. May Measurement Month (MMM) is an annual global initiative which began in 2017 aimed at raising awareness of high BP. Hungary, through the Hungarian Society of Hypertension has joined the campaign of MMM from the beginning. The results of years 2017 and 2019 are presented in this paper. ]

Clinical Neuroscience

[Diseases with peripheral motor symptoms ]

DELI Gabriella, KOMÁROMY Hedvig, PÁL Endre, PFUND Zoltán

[Diseases with peripheral motor symptoms are a rare, but important subgroup of the all peripheral neuropathies, radiculopathies and neuronopathies. In these mostly progressive neuropathies, the clinical features include pure motor symptoms with weakness and wasting of the striated muscles. The differentiation of these diseases is frequently a challenge for qualified clinical neurologists. A careful history taking, the disease time course, the findings of routine clinical physical examination and the electrophysiological studies are all necessary in the diagnostic procedure. The aim of this publication is to overview the clinical characteristics of the pure motor peripheral neuropathies, to consider the diagnostic steps and the differential diagnosis, and finally to summarize the treatment options. ]

Hypertension and nephrology

[Subtype diagnosis, treatment, complications and outcomes of primary aldosteronism and future direction of research: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension – excerpts]

KOVÁTS Viktória, ALFÖLDI Sándor

[Primary aldosteronism is a frequent cause of secondary hypertension requiring a specific pharmacological treatment with mineralocorticoid receptor antagonist or with unilateral adrenalectomy. These treatments have shown to reduce the excess of cardiovascular risk characteristically associated with this disease. In this consensus, we discussed the procedures for the diagnosis of primary aldosteronism, we address the strategies for the differential diagnosis of primary aldosteronism subtypes and therapy. We also discuss the evaluation of outcomes and provide suggestions for follow-up as well as cardiovascular and metabolic complications specifically associated with primary aldosteronism. ]