Abstract
J,P GENDRE. Preventing relapse in Crohn'!> disease. Can J Gastroenterol 1993;7(2):237,240. Prcvcncmg rd.1pse rcm:uns a main challl.'nge in Crohn's di~eru.c. Three Jifkrcnt clinical situations should be cons1dcreJ separately. Fm,t, in patients in clinILal remission, the most useful drugs might be ~ulphasalazinc and its dcnvarivcs. Only 5-aminosalicylic acid ( 5-ASA ) has hecn l>hown to be l'ffectlvc m such pat 1enrs. lt b likely that 5-ASA, at a Jl)sc from 2 co 3 g per day, reduces the rdapSl' rate, particularly when used l.!arly ,1trer achic\'ing remission. \Vhat is che proper dosage? How long must the treamwnt last? Must patients with a long-standing remission be treated? The three question:, remam unans\\ercJ. Second, in patients clinically :md macro:,copically in remission seen immediately after surgery, then.· is no evidence of any drug dticacy co prevent clinical and/or endoscopic recurrence, but there is a slight trend in favl.1ur of 5-ASA. Third, in patients with chronic, mildly active discasl, when surgery must be ,\V\.lldcd because of anttdparcd dis:1bling con~cqul'l1Ct's, unmuno-supprcssants such as azathtoprme anJ/1.x 6-mcrcaptopurine seem the most appropn,1te anJ cffccnve Jrugs. Usctulness <1f methtotrexate and/or cyclosporine needs evaluation.
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