...15 | 3-5 2016

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:

%

1979 Sulfasalazine, 1980 , , 6-MP19935-ASA199419951998Infliximab20042

Anti-TNF

Infliximab (Remicade) - Crohns & UCAdalimumab (Humira) - Crohns & UCCertolizumab (Cimzia) - Crohns Golimumab (Simponi) - UC

Natalizumab (Tysabri) - Crohns Vedolizumab (Entyvio) - UC > Crohns

http://synapse.koreamed.org/ArticleImage/0143IR/ir-10-26-g003-l.jpg

http://synapse.koreamed.org/ArticleImage/0143IR/ir-10-1-g001-l.jpg

Infliximab (IFX) IgG1 (75%) (25%) TNF- DNA

IFX

Crohn / ,

, , 6-MP AZA,

IFX

Crohn, , IFX Crohn , IFX 3 (6 )

IFX , IFX :

10 mg/kg ( 5 mg/kg) 4 wk ( 8) , 90%

H IFX , IFX IFX , IFX

Adalimumab (ADA) IgG1 TNF- (hamster) DNA

ADA

Crohn , / ,

6-MP AZA,

ADA

:

80 mg 2 wks 40 mg

Crohn, 12 , ADA

, 8 , ADA

ADA

Certolizumab pegol, TNF-,

Golimumab IgG1 DNA

Golimumab

Crohn

6-MP AZA,

Golimumab (0,5 mL 50 mg golimumab)

Golimumab

Natalizumab, -4-

Vedolizumab IgG1 47 K (hamster)

vedolizumab

Crohn Crohn, , anti-TNF-

, anti-TNF-

Vedolizumab

Crohn, vedolizumab 300 mg 4 wk

Crohn , wk 14

, wk 10

Vedolizumab

SONIC ( Crohn) SUCCESS ( ): IFX+AZA IFX ( / )

, ( Crohn) anti-TNF

Danese S, et al. Nat Rev Gastroenterol Hepatol 2015 (in press)

ECCOLink: http://peptiko.gr Crohn

* (DDW 2016)*

(EBV, HIV, CMV, HSV, HBV, HCV, HPV, VZV)(Strep, Staph, Mycobact)(HistoplasmosisCoccidiosis)C. difficileStopMay need to stop +Rx virus

Individualize who to restart 6MP/AZAStop +RxThen individualizeStop +RxThen restart when clearedContinueAnti-TNFContinueProb ok to continue, except active hepBStop +RxThen individualizeStop +RxThen restart when clearedContinueAnti-ContinueContinueContinueContinue

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