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Abordagem farmacoterapêutica das doenças inflamatórias do intestino
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Resumo(s)
As doenças inflamatórias do intestino são doenças crónicas e, normalmente, são divididas na doença de Crohn e na Colite Ulcerosa. A sua patogénese é ainda mal conhecida, apesar de se pensar que tem como base a autoimunidade. Também a sua fisiopatologia não está completamente elucidada, principalmente devido à sua complexidade e à quantidade de intervenientes. O presente trabalho teve como objetivo principal apresentar as terapêuticas existentes mais recentes, ao mesmo tempo que se discutiu a patogénese, fisiopatologia e métodos diagnóstico da doença de Crohn e da Colite Ulcerosa. Foi também feita uma análise crítica às guidelines mais recentes do Instituto Nacional para a Excelência da Clínica e da Saúde (NICE), do Colégio Americano de Gastroenterelogia (ACG) e da Organização Europeia da Doença de Crohn e Colite (ECCO). Chegou-se à conclusão que as guidelines têm uma aproximação cautelosa, tendo em conta a melhor razão custo-benefício e que se a terapia inicial for mais agressiva poder-se-iam minimizar custos, em aspetos não relacionados diretamente com a terapia, tais como o aumento da qualidade de vida do doente e a diminuição das morbilidades.
Inflammatory bowel diseases are chronic diseases and are generally divided in Crohn’s disease and Ulcerative Colitis. Their pathogenesis is still not well known, although autoimmunity has a big role in it. The physiopathology is also not completely elucidated, mainly due to its complexity and number of intervenient agents. The main objective of this work was to present the most recent therapies and, at the same time, to discuss the pathogenesis, physiopathology and the diagnosis of Crohn’s disease and Ulcerative Colitis. A critical analysis was also made to the most recent guidelines of the National Institute for Clinical Excellence (NICE), the American College of Gastroenterology (ACG) and the European Crohn’s and Colitis Organization (ECCO). One of the conclusions of this study is that these guidelines have a cautious approach to the treatment of the IBD, trying to achieve the best cost to benefit ratio, but it seems that an early aggressive therapy might be able to minimize the indirect costs of the disease, improving the quality of life of the patients and diminishing the diseases’ morbidity.
Inflammatory bowel diseases are chronic diseases and are generally divided in Crohn’s disease and Ulcerative Colitis. Their pathogenesis is still not well known, although autoimmunity has a big role in it. The physiopathology is also not completely elucidated, mainly due to its complexity and number of intervenient agents. The main objective of this work was to present the most recent therapies and, at the same time, to discuss the pathogenesis, physiopathology and the diagnosis of Crohn’s disease and Ulcerative Colitis. A critical analysis was also made to the most recent guidelines of the National Institute for Clinical Excellence (NICE), the American College of Gastroenterology (ACG) and the European Crohn’s and Colitis Organization (ECCO). One of the conclusions of this study is that these guidelines have a cautious approach to the treatment of the IBD, trying to achieve the best cost to benefit ratio, but it seems that an early aggressive therapy might be able to minimize the indirect costs of the disease, improving the quality of life of the patients and diminishing the diseases’ morbidity.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2013
Palavras-chave
Doenças inflamatórias do intestino Doença de Crohn Colite ulcerosa Terapêutica Mestrado Integrado - 2013