The full content of Annals is available to subscribers

Subscribe/Learn More  >
Reviews |

Advances in Drug Therapy for Inflammatory Bowel Disease

Mark A. Peppercorn, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Mark A. Peppercorn, MD, Beth Israel Hospital, Dana 501, 330 Brookline Avenue, Boston, MA 02215.

Current Author Address: Dr. Peppercorn: Beth Israel Hospital, Dana 501, 330 Brookline Avenue, Boston, MA 02215.

© 1990 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1990;112(1):50-60. doi:10.7326/0003-4819-112-1-50
Text Size: A A A

Purpose: To identify advances in drug therapy for inflammatory bowel disease, and to evaluate the effectiveness of the new agents in treating both ulcerative colitis and Crohn disease.

Data Identification: Studies published from January 1980 through June 1989 were identified using MEDLINE and through extensive hand searching of bibliographies in identified articles.

Study Selection: One hundred and ten articles directly related to the topic were found and analyzed. Another 42 articles were relevant to the material reviewed.

Data Extraction: Articles were selected on the basis of study quality and their significance with regard to treatment of inflammatory bowel disease.

Results of Data Analysis: The aminosalicylates are emerging as effective and safe therapy for inflammatory bowel disease. Corticotropin can be considered the drug of choice for certain patients with severe ulcerative colitis, and new rapidly metabolized topical steroids appear to be as effective as traditional forms and have fewer side effects. Immunosuppressive agents, including 6-mercaptopurine and azathioprine, may be useful in treating difficult-to-manage patients with either Crohn disease or ulcerative colitis, whereas cyclosporin appears promising but should be reserved for patients in whom other measures have failed. Patients with refractory perineal Crohn disease and those with Crohn colitis may benefit from metronidazole. Many other drugs including clonidine, cromoglycate, chloroquine, fish oil, methotrexate, antituberculous agents, interferon, and superoxide dismutase have shown enough promise in preliminary studies to warrant controlled clinical trials.

Conclusions: Drug therapy for inflammatory bowel disease, limited for many years to sulfasalazine and some corticosteroids, has been extended to include the aminosalicylates, rapidly metabolized topical steroids, immunosuppressive agents, and metronidazole. Potentially useful newer drugs await further study.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.