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Decis?es clínicas na doen?a de CrohnKeywords: crohn disease. Abstract: 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 clínicos 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
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