{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282679834516608.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.3862/jcoloproctology.70.601"}},{"identifier":{"@type":"URI","@value":"https://www.jstage.jst.go.jp/article/jcoloproctology/70/10/70_601/_pdf"}},{"identifier":{"@type":"NAID","@value":"130006179284"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2018148549"}}],"dc:title":[{"@language":"ja","@value":"II．Crohn病内科的治療の最前線"},{"@language":"en","@value":"Recent Advances in the Medical Treatment of Crohn's Disease"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"The development of anti-TNFα mAbs has dramatically changed the therapeutic strategy for Crohn's disease. A “treat to target” strategy has been introduced in IBD management to improve long-term outcomes. Recently, mucosal healing has been accepted as a therapeutic goal. To obtain the maximum effect of anti-TNFα mAbs, monitoring of disease activity is very important. Serum CRP and fecal calprotectin may be used as non-invasive biomarkers for monitoring disease activity in daily practice. It is also important to review existing treatments. Concomitant use of thiopurines should be considered for each patient. Enteral nutrition therapy is a conventional therapy for Crohn's disease. In recent years, a combination with anti-TNF therapy has been studied as a new strategy for EN therapy. After widespread use of anti-TNFα mAbs, we are facing new problems such as loss of response to anti-TNFα mAbs.<BR>It is important to understand the mechanism of loss of response for managing such patients. Recently, ustekinumab, which is an anti-IL-12/23p40 mAb, became available for the treatment of Crohn's disease in Japan, and is expected as a new effective therapy for patients who are resistant and no longer respond to anti-TNFα mAbs."},{"@language":"ja","@value":"抗TNFα抗体製剤の開発はCrohn病の治療ストラテジーを大きく変えた．長期的予後を改善するために“treat to target”ストラテジーが取り入れられ，粘膜治癒が治療目標として提唱された．疾患活動性のモニタリングが重要であり，血清CRPと便カルプロテクチンが日常臨床での非侵襲的バイオマーカーとして期待されている．既存治療の見直しとして，チオプリン製剤の併用については個々の患者において検討されるべきである．経腸栄養療法についても抗TNFα抗体製剤との併用療法の有用性が検討されている．抗TNFα抗体製剤が広く使用されるようになるにつれて，効果減弱を含む新たな問題にも直面しておりその機序を理解することが重要である．新たな治療薬として抗Il-12/23p40抗体であるウステキヌマブが日本でも承認された．抗TNFα抗体製剤に対する一次無効患者や効果減弱患者に対する有効性が期待されている．"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1420845751163719296","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"60255437"},{"@type":"NRID","@value":"1000060255437"},{"@type":"NRID","@value":"9000024273144"},{"@type":"NRID","@value":"9000368940505"},{"@type":"NRID","@value":"9000391772744"},{"@type":"NRID","@value":"9000361240832"},{"@type":"NRID","@value":"9000002873945"},{"@type":"NRID","@value":"9000022133619"},{"@type":"NRID","@value":"9000265248562"},{"@type":"NRID","@value":"9000257926869"},{"@type":"NRID","@value":"9000414080125"},{"@type":"NRID","@value":"9000308376387"},{"@type":"NRID","@value":"9000399817895"},{"@type":"NRID","@value":"9000391777809"},{"@type":"NRID","@value":"9000396146815"},{"@type":"NRID","@value":"9000258205359"},{"@type":"NRID","@value":"9000313201261"},{"@type":"NRID","@value":"9000242076256"},{"@type":"NRID","@value":"9000242144173"},{"@type":"NRID","@value":"9000342449077"},{"@type":"NRID","@value":"9000391780806"},{"@type":"NRID","@value":"9000404111972"},{"@type":"NRID","@value":"9000398301866"},{"@type":"NRID","@value":"9000025054181"},{"@type":"NRID","@value":"9000001021573"},{"@type":"NRID","@value":"9000242076351"},{"@type":"NRID","@value":"9000396145312"},{"@type":"NRID","@value":"9000265248416"},{"@type":"NRID","@value":"9000335185281"},{"@type":"NRID","@value":"9000326658567"},{"@type":"NRID","@value":"9000400159840"},{"@type":"NRID","@value":"9000005761872"},{"@type":"NRID","@value":"9000391775079"},{"@type":"NRID","@value":"9000391776657"},{"@type":"NRID","@value":"9000345259271"},{"@type":"NRID","@value":"9000404111989"},{"@type":"NRID","@value":"9000273022515"},{"@type":"NRID","@value":"9000323303181"},{"@type":"NRID","@value":"9000317144108"},{"@type":"NRID","@value":"9000399162211"},{"@type":"NRID","@value":"9000391776508"},{"@type":"NRID","@value":"9000403839891"},{"@type":"NRID","@value":"9000403995786"},{"@type":"NRID","@value":"9000378657921"},{"@type":"NRID","@value":"9000366126419"},{"@type":"NRID","@value":"9000356551538"},{"@type":"NRID","@value":"9000391780074"},{"@type":"NRID","@value":"9000283916523"},{"@type":"NRID","@value":"9000345401347"},{"@type":"NRID","@value":"9000242075967"},{"@type":"NRID","@value":"9000356551957"},{"@type":"NRID","@value":"9000337071477"},{"@type":"NRID","@value":"9000391771157"},{"@type":"NRID","@value":"9000396146762"},{"@type":"NRID","@value":"9000265248408"},{"@type":"NRID","@value":"9000016778496"},{"@type":"NRID","@value":"9000399817334"},{"@type":"NRID","@value":"9000283915188"},{"@type":"NRID","@value":"9000283915138"},{"@type":"NRID","@value":"9000242075198"},{"@type":"NRID","@value":"9000403976519"},{"@type":"NRID","@value":"9000283665429"},{"@type":"NRID","@value":"9000308378796"},{"@type":"NRID","@value":"9000326658585"},{"@type":"NRID","@value":"9000265248500"},{"@type":"NRID","@value":"9000366502204"},{"@type":"NRID","@value":"9000345401669"},{"@type":"NRID","@value":"9000309181007"},{"@type":"NRID","@value":"9000402925102"},{"@type":"NRID","@value":"9000397939371"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/read0121550"}],"foaf:name":[{"@language":"ja","@value":"久松 理一"},{"@language":"en","@value":"Hisamatsu Tadakazu"}],"jpcoar:affiliationName":[{"@language":"en","@value":"The Third Department of Internal Medicine, Kyorin University School of Medicine"},{"@language":"ja","@value":"杏林大学医学部第三内科学"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"00471801"},{"@type":"LISSN","@value":"00471801"},{"@type":"EISSN","@value":"18829619"}],"prism:publicationName":[{"@language":"en","@value":"Nihon Daicho Komonbyo Gakkai Zasshi"},{"@language":"ja","@value":"日本大腸肛門病学会雑誌"},{"@language":"en","@value":"Nihon Daicho Komonbyo Gakkai Zasshi"},{"@language":"en","@value":"Journal of Japan Society of Coloproctology"},{"@language":"en","@value":"J Jpn Soc Coloproctol"},{"@language":"ja","@value":"日本大腸肛門病会誌"},{"@language":"en","@value":"J. Jpn. Soc. Colo-proctol"},{"@language":"ja","@value":"日本大腸肛門病学会雑誌"}],"dc:publisher":[{"@language":"en","@value":"The Japan Society of Coloproctology"},{"@language":"ja","@value":"一般社団法人日本大腸肛門病学会"}],"prism:publicationDate":"2017","prism:volume":"70","prism:number":"10","prism:startingPage":"601","prism:endingPage":"610"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","url":[{"@id":"https://www.jstage.jst.go.jp/article/jcoloproctology/70/10/70_601/_pdf"},{"@id":"https://search.jamas.or.jp/link/ui/2018148549"}],"availableAt":"2017","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=Crohn%E7%97%85","dc:title":"Crohn病"},{"@id":"https://cir.nii.ac.jp/all?q=%E6%8A%97TNF%CE%B1%E6%8A%97%E4%BD%93","dc:title":"抗TNFα抗体"},{"@id":"https://cir.nii.ac.jp/all?q=treat%20to%20target","dc:title":"treat to target"},{"@id":"https://cir.nii.ac.jp/all?q=%E7%B2%98%E8%86%9C%E6%B2%BB%E7%99%92","dc:title":"粘膜治癒"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%8A%B9%E6%9E%9C%E6%B8%9B%E5%BC%B1","dc:title":"効果減弱"},{"@id":"https://cir.nii.ac.jp/all?q=Crohn's%20disease","dc:title":"Crohn's disease"},{"@id":"https://cir.nii.ac.jp/all?q=anti%E2%80%93TNF%CE%B1%20mAb","dc:title":"anti–TNFα mAb"},{"@id":"https://cir.nii.ac.jp/all?q=treat%20to%20target","dc:title":"treat to target"},{"@id":"https://cir.nii.ac.jp/all?q=mucosal%20healing","dc:title":"mucosal healing"},{"@id":"https://cir.nii.ac.jp/all?q=loss%20of%20response","dc:title":"loss of response"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360002215326527744","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"C-reactive protein is an indicator of serum infliximab level in predicting loss of response in patients with Crohn’s disease"}]},{"@id":"https://cir.nii.ac.jp/crid/1360004233739024128","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Comparison of Magnetic Resonance and Balloon Enteroscopic Examination of the Small Intestine in Patients With Crohn's Disease"}]},{"@id":"https://cir.nii.ac.jp/crid/1360011143583884032","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Mongersen, an Oral <i>SMAD7</i> Antisense Oligonucleotide, and Crohn’s Disease"}]},{"@id":"https://cir.nii.ac.jp/crid/1360011144135686144","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"A Matrix-based Model Predicts Primary Response to Infliximab in Crohn’s Disease"}]},{"@id":"https://cir.nii.ac.jp/crid/1360011145293567488","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"A Genetic Variation in the Neonatal Fc-Receptor Affects Anti-TNF Drug Concentrations in Inflammatory Bowel Disease"}]},{"@id":"https://cir.nii.ac.jp/crid/1360283690263643904","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Findings of ulceration and severe stricture on MRE can predict prognosis of Crohn’s disease in patients treated with anti-TNF treatment"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292619137844992","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Crohn's disease management after intestinal resection: a randomised trial"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292620609889152","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Has There Been a Change in the Natural History of Crohn's Disease? 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