gastrointestinal (GI) tract, usually the small intestine and/or colon. Symptoms
can include persistent diarrhea, abdominal pain, fever, and rectal bleeding.
Loss of appetite and subsequent weight loss may also occur. The disease is
not always limited to the GI tract; it sometimes also affects the joints, eyes,
skin, and liver. The immune system reacts inappropriately, sometimes
mistaking food and normal bacteria in the intestine for foreign substances and
launching an attack. In the process, the body sends white blood cells into the
lining of the intestines, where they produce chronic inflammation.
So far, there is no cure; the primary treatment goal is to improve immune
system regulation to suppress the inflammatory response. This allows the
intestinal tissue to heal and relieves the symptoms. After the symptoms are
brought under control, medical therapy is used to decrease the frequency of
disease flare-ups and to maintain remission.
Approximately 500,000 Americans have Crohn`s disease. Data from
MediMedia`s Hospital Diagnosis & Therapy Audit indicate that approximately
160,000 patients with the disease are hospitalized each year. Although men
and women are affected equally, more females are hospitalized
Crohn`s disease affects people of all ages, but it is most common in
adolescents and young adults, mainly those between 15 and 35 years of age.
In 1998, the Food and Drug Administration approved infliximab (Remicade?,
Centocor), a biological therapy, to treat moderately to severely active Crohn`s
disease in patients who responded inadequately to conventional therapy and
to reduce the number of draining enterocutaneous fistulas. This antibody
binds to tumor necrosis factor (TNF), an immune system protein with a role in
inflammation. TNF is produced by white blood cells and is thought to cause
many of the symptoms and tissue injury in Crohn`s disease.
Fewer than 7% of patients received infliximab in the hospital
however, it should be noted that the drug is not given daily and is usually
administered in a physician`s office. The hospital market represents only the
more severe cases of disease and patients with serious comorbidities.
The data cited in this article are available free of charge to hospitals
participating in the PharmScope Insights program. The program specializes in
helping hospital pharmacies target areas for performance improvement by
providing benchmarks from a panel of 80 hospitals nationwide. To learn about
joining PharmScope Insights, a division of MediMedia USA, Inc., visit
www.mminfotech.com and click on Hospitals.
■ 기사 요지
`메디메디아USA` 발간 `P&T(Pharmacy and therapeutics)` 1월호에 게재된 내용이다.
크론병은 소장이나 결장 등 위장관에 염증을 야기하는 만성장애 일종이다. 하지만 반드시
위장관 부위에 발병하는 것은 아니고, 관절·눈·피부·간 등에도 일부 영향을 미친다. 현재로서
는 완치할 수 있는 방법이 없다. 따라서 주요 치료목표는 염증반응을 억제할 수 있도록 체내
면역체계를 개선시키는 것이다.
이를 통해 장조직이 증상을 치료 및 완화할 수 있도록 돕고, 일단 증상이 조절되면 재발을
막고 호전상태를 유지할 수 있도록 치료를 병행해야 한다. 메디메디아 자료에 의하면, 미국에
서만 대략 50만명이 크론병으로 고통받고 있으며, 연간 16만명이 이 질병으로 병원에 입원한
다. 여성과 남성 모두 영향을 받지만 여성의 입원율이 더 높은 것으로 나타났다<그림 1>.
FDA는 1998년 기존 치료로 효과를 보지 못하는 중등도에서 중증의 크론병환자 치료제로
infliximab(Remicade)을 승인했다. 2002·2003년 미국내 크론병 입원환자 중 infliximab
치료환자는 7%를 넘지 않았으나, 1일 용법이 아니라 진찰실에서 의사에 의해 투여된다는 점
을 고려해야 한다. 정리·이상돈 기자
sdlee@kimsonline.co.kr