Orphan patients with inflammatory bowel disease-when we treat beyond evidence  

作　　者：Giuseppe Privitera Daniela Pugliese Loris Riccardo Lopetuso Franco Scaldaferri Alfredo Papa GianLodovico Rapaccini Antonio Gasbarrini Alessandro Armuzzi 

机构地区：[1]Dipartimento Universitario di Medicina e Chirurgia Traslazionale,UniversitàCattolica del Sacro Cuore,Rome 00168,Italy [2]CEMAD–IBD UNIT-UnitàOperativa Complessa di Medicina Interna e Gastroenterologia,Dipartimento di Scienze Mediche e Chirurgiche,Fondazione Policlinico Universitario"A.Gemelli"IRCCS,Rome 00168,Italy [3]CEMAD–IBD UNIT-UnitàOperativa Complessa di Medicina Interna e Gastroenterologia,Dipartimento di Scienze Mediche e Chirurgiche,Fondazione Policlinico Universitario“A.Gemelli”IRCCS,Rome 00168,Italy [4]Department of Medicine and Ageing Sciences,“G.d’Annunzio”University of Chieti-Pescara,Chieti 66100,Italy [5]Center for Advanced Studies and Technology(CAST),“G.d’Annunzio”University of Chieti-Pescara,Chieti 66100,Italy

出　　处：《World Journal of Gastroenterology》2021年第47期8047-8057,共11页世界胃肠病学杂志（英文版）

摘　　要：Inflammatory bowel disease(IBD)is a chronic condition that requires continuous medical treatment.To date,the medical management of patients with moderatelyto-severely active IBD who develop dependence or resistance to corticosteroids is based on immunomodulator drugs.Such therapies are licenced after passing through three phases of randomized controlled trials(RCTs),and are subsequently adopted in clinical practice.However,the real-life population of IBD patients who require these therapies can significantly differ from those included in RCTs.As a matter of fact,there is a number of exclusion criteria–nearly ubiquitous in all RCTs–that prevent the enrolment of specific patients:Chronic refractory pouchitis or isolated proctitis in ulcerative colitis,short-bowel syndrome and stomas in Crohn’s disease,ileorectal anastomosis in both ulcerative colitis and Crohn’s disease,and elderly age are some representative examples.In this frontier article,we aim to give an overview of current literature on this topic,in order to address the main knowledge gaps that need to be filled in the upcoming years.

关 键 词：POUCHITIS PROCTITIS STOMA Short-bowel Ileo-rectal anastomosis BIOLOGICS 

分 类 号：R725.7[医药卫生—儿科]