%0 Journal Article
%T Decis£¿es cl¨ªnicas na doen£¿a de Crohn
%A Magro
%A Fernando
%A Correia
%A Luis
%A Lago
%A Paula
%A Macedo
%A Guilherme
%A Peixe
%A Paula
%A Portela
%A Francisco
%A Dias
%A Jorge Amil
%A Barros
%A Lu¨ªsa
%A Belo
%A Teresa
%A Caldeira
%A Paulo
%A Cerqueira
%A Rute
%A Chagas
%A Cristina
%A Correia
%A Manuel
%A Ferreira
%A An¨ªbal
%A Freire
%A Paulo
%A Gon£¿alves
%A Ana Rita
%A Gon£¿alves
%A Raquel
%A Herculano
%A Rita
%A Lopes
%A Susana
%A Santos
%A Paula Moura
%A Machado
%A Artur
%A Morna
%A Henrique
%A Pimentel
%A Rita
%A Ramos
%A Jaime
%A Reis
%A Jorge
%A Rodrigues
%A Susana
%A Rosa
%A Isadora
%A Salgado
%A Marta
%A Vasconcelos
%A Helena
%A Vieira
%A Ana Isabel
%J Jornal Portugu¨ºs de Gastrenterologia
%D 2012
%I Sociedade Portuguesa de Gastrenterologia
%X introduction: crohn¡¯s disease is a chronic inflammatory disease from gastrointestinal tract. the increase in incidence and heterogeneity of this pathology, with different presentations and prognostics leads to a constant concern in developing and improving its classification and treatment. objectives: to establish recommendations (based on level of evidence and recommendation grades) to 5 questions considered as the clinical challenges of the therapeutic approach in crohn¡¯s disease. methods: the methodology adopted by the working group dc2 (desafios cl¨ªnicos na doen£¿a de crohn) was based on the selection of 5 questions, by voting, and establishing recommendations to each question proposed to each subgroup. discussion and approval of reflexions and final recommendations was carried out in a consensus meeting. conclusion: it has been possible to base conclusions about the questions under study on evidence, being recommended: 1) having crohn¡¯s disease under 40 years old, structuring phenotype disease and anal disease are predictive factors of bad prognostic; 2) it is possible to consider suspension of biologics in patients with endoscopic remission and normal biomarkers; 3) patients with biochemical markers of disease activity (crp and calprotectina) have more probability of relapse; 4) in failure of biologics it is essential to assure that treatment with the first drug was optimized: with infliximab it¡¯s demonstrated that either reduction of the administration range or increasing the dose allows to recover the response in the majority of patients; as for adalimumab, patients should change from bimonthly to weekly administrations; 5) in case of crohn¡¯s disease with intestinal surgery, use of therapeutic to reduce postoperative recurrence is indicated, particularly immunosupressors and biologics
%K crohn disease.
%U http://www.scielo.gpeari.mctes.pt/scielo.php?script=sci_abstract&pid=S0872-81782012000200005&lng=en&nrm=iso&tlng=en