Reviews in gastroenterological disorders
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Rev Gastroenterol Disord · Jan 2007
ReviewMedical therapy for gastroesophageal reflux disease in 2007.
Maximizing therapy for the patient with symptomatic gastroesophageal reflux disease (GERD) and optimizing efficacy of available agents in the difficult or refractory patient requires an understanding of antisecretory pharmacology and pharmacodynamics. Recent studies raise issues related to potential side effects of proton pump inhibitors (PPIs). Non-acid reflux and its potential association with symptoms must be considered in the management of refractory patients. Medical therapy of GERD is discussed, emphasizing optimizing antisecretory therapy, reviewing recent studies addressing potential side effects of PPIs and options for treatment of non-acid reflux.
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Rev Gastroenterol Disord · Jan 2007
ReviewClinical perspectives in Crohn's disease. Moving forward with anti-TNF-alpha therapy: current needs and future treatments.
Although infliximab continues to make an important contribution to the management of Crohn's disease, its use includes several clinical challenges, including loss of response, loss of tolerability due to acute and delayed infusion reactions, and the need for intravenous administration by a health care provider. Newer anti-tumor necrosis factor-a agents such as certolizumab pegol and adalimumab have been shown in clinical trials to have similar efficacy as infliximab, without the acute and delayed infusion reactions. Further information is needed about infliximab, certolizumab pegol, and adalimumab so we can understand the relationships among these 3 agents in terms of antibody formation, drug concentration, dosing (episodic vs systematic maintenance), concomitant immunosuppressive therapy, and efficacy.