Table 1.

Existing treatments.

Treatment	Main probable mechanism(s) of action	Available formulations	Indication	Side effects	Pros	Cons
Aminosalycilates	PPAR-γ agonism Inhibition of arachidonic acid metabolism Inhibition of lymphocytes proliferation	Oral and topical	Induction and maintenance of remission	Hypersensitivity reactions Interstitial nephritis Acute pancreatitis Blood disorders	Low incidence of side effects Availability of many different formulation for different disease localization	Not suitable for severe disease
Steroids	Inhibition of NF-κB activation	Oral, topical and parenteral	Induction of remission	Hyperglicemia Hypertension Osteoporosis Cataracts Glaucoma Psycosis Skin fragility Malar fat pad increase Visceral and truncal fat deposition Adrenal insufficiency Increased infection	Good efficacy Availability of many different formulation for different disease localization and severity	High rate of side effects Not suitable for maintenance treatment
Low bioavailability steroids	Inhibition of NF-κB activation	Oral and topical	Induction of remission	Theoretically the same as steroids	Low incidence of side effects Availability of different formulation for different disease localization	Not suitable for severe disease
Azathioprine 6-Mercaptpurine	Inhibition of leukocyte proliferation Induction of lymphocyte apoptosis	Oral	Maintenance of remission	Leukopenia Hepatitis Pancreatitis Hypersensitivity Increased risk of lymphoma (?)	Usually well tolerated	Delayed therapeutic effect Not suitable in a subset of patients because of intolerance/side effects
Cyclosporine	Inhibition of calcineurin	Oral and parenteral	Induction and maintenance of remission	Hypertension Nephropaty Potassium retention Gengival hyperplasia Increased infections	Fast therapeutic effect Suitable for induction, much less for maintenance of remission	High incidence of side effects
Infliximab	Circulating and membrane-bound TNF-α blockade Apoptosis of TNF-α producing cells	Parenteral	Induction of remission Maintenance of remission (?)	Allergic reactions Increased risk of serious infection Heart failure in cardiopathic patients	Good efficacy Fast therapeutic effect	Expensive Unknown long-term effects
Leukocytoapheresys	Physical removal of activated leukocytes Induction of immune tolerance	Not applicable	Induction of remission	Few and minor	Safe	Data not clear regarding efficacy