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Abstract(s)
Em qualquer das suas vertentes principais, colite ulcerosa ou doença de Crohn, a doença inflamatória intestinal é uma patologia com grande impacto na sociedade: comummente associada à ocorrência de quadros alternados de exacerbação aguda e de remissão parcial ou total dos sintomas, é globalmente considerada como uma doença incapacitante e responsável pela diminuição acentuada da qualidade de vida do paciente.
Ainda sem cura conhecida, o tratamento da doença inflamatória intestinal assenta actualmente no controlo sintomático através de terapêutica convencional com ácido 5-aminosalicílico e corticóides, uma abordagem que é eficaz na grande maioria dos casos. Contudo, uma minoria de situações não irá obter resposta com estas medidas farmacológicas; quadros patológicos mais severos irão necessitar de um tratamento mais intensivo com imunossupressores e agentes biológicos, fármacos que poderão estar associados à vantagem adicional de indução da cicatrização das lesões da mucosa intestinal. Esta possibilidade, a concretizar-se, poderá estar associada à alteração da história natural da doença, de acordo com investigações recentes, resultando numa melhor qualidade de vida e na minimização das complicações a curto, médio e longo prazo para o paciente. No entanto, as questões práticas relativas à segurança destas novas opções terapêuticas não podem ser desconsideradas.
Será objectivo deste trabalho a revisão teórica da evidência científica até à data relativamente ao papel dos imunossupressores e dos agentes biológicos na manutenção terapêutica da doença inflamatória intestinal e até que ponto a sua utilização será, a longo prazo, mais benéfica para a situação clínica dos pacientes quando em comparação com os tratamentos convencionais.
In both of its major types, ulcerative colitis and Crohn’s disease, inflammatory bowel disease has a high impact on society: commonly associated with the alternation of episodes of acute exacerbation and partial or total remission of symptoms, it’s globally regarded as a disabling disease, responsible for the acute decrease of the patient’s quality of life. Without a known cure yet, the treatment for inflammatory bowel disease is currently built upon the symptomatic control through a conventional treatment with 5-aminosalicylic acid and corticoids, which is effective in most cases. However, a small minority won’t respond to these pharmacologic measures; severe clinical presentations will need an intensive treatment with immunosuppressants and biological agents, both possibly linked to the healing of gut mucosal lesions. This possibility, if real, can be associated to a change in the natural history of the disease, according to recent conclusions, which can result in a better quality of life and a minimization of complications in a short, medium and long term to the patient. The practical questions concerning the safety of these new therapeutic options, however, cannot be disregarded. The theoretical revision of the scientific evidence available until the moment regarding the role of immunosuppressants and biological agents in the therapeutic maintenance of the inflammatory bowel disease, and whether its use will, in long term, be more benefic to the patients’ clinical situation when compared to the conventional treatments, will be the main purpose of this work.
In both of its major types, ulcerative colitis and Crohn’s disease, inflammatory bowel disease has a high impact on society: commonly associated with the alternation of episodes of acute exacerbation and partial or total remission of symptoms, it’s globally regarded as a disabling disease, responsible for the acute decrease of the patient’s quality of life. Without a known cure yet, the treatment for inflammatory bowel disease is currently built upon the symptomatic control through a conventional treatment with 5-aminosalicylic acid and corticoids, which is effective in most cases. However, a small minority won’t respond to these pharmacologic measures; severe clinical presentations will need an intensive treatment with immunosuppressants and biological agents, both possibly linked to the healing of gut mucosal lesions. This possibility, if real, can be associated to a change in the natural history of the disease, according to recent conclusions, which can result in a better quality of life and a minimization of complications in a short, medium and long term to the patient. The practical questions concerning the safety of these new therapeutic options, however, cannot be disregarded. The theoretical revision of the scientific evidence available until the moment regarding the role of immunosuppressants and biological agents in the therapeutic maintenance of the inflammatory bowel disease, and whether its use will, in long term, be more benefic to the patients’ clinical situation when compared to the conventional treatments, will be the main purpose of this work.
Description
Keywords
Doença inflamatória intestinal Doença inflamatória intestinal - Terapêutica imunossupressora Doença inflamatória intestinal - Terapêutica biológica Doença de Crohn Colite ulcerosa
Pedagogical Context
Citation
Publisher
Universidade da Beira Interior