هذا البوست موجة لكل اطباء الجهاز الهضمي في مصر والوطن العربي
🗒️2024 ECCO
Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment
1️⃣ 5-ASA is not recommended
🚫for the induction or maintenance therapy in CD
➡️consistent lack of evidence.
2️⃣ Budesonide is recommended for inducing clinical remission in patients with active, mild-to-moderate CD limited to the ileum / ascending colon
👉Additionally, systemic corticosteroids are suggested for induction therapy in patients with active, moderate-to-severe CD
3️⃣Thiopurine monotherapy is not recommended for induction therapy in CD, but it can be considered for maintenance
4️⃣Parenteral
methotrexate
is suggested for both induction and maintenance therapy in moderate-to-
severe CD
5️⃣ Infliximab
➡️induction and maintenance for mod/sev active CD
👉Use combination with thiopurine during the induction and continue 6–12 months
Patients who achieve long-term remission with this combination
➡️de-escalation to infliximab monotherapy and withdrawal of thiopurines
6️⃣ Adalimumab is recommended as both induction and maintenance therapy for patients with moderate-to-severe CD
👉For those bionaïve, Adalimumab monotherapy
💪is preferred over combination therapy with thiopurines during induction and maintenance.
7️⃣Certolizumab
is suggested for both induction and maintenance therapy in moderate-to-severe CD.
🎱 There is insufficient evidence to recommend proactive therapeutic drug monitoring over reactive monitoring or standard care for anti-TNF agents
🔥Controversy here
!
9️⃣Ustekinumab is recommended for both induction and maintenance therapy in moderate-to-severe CD
🔟Adalimumab and ustekinumab
🆚 are suggested to be equally effective
🟰 for both induction and maintenance therapy in biologic-naïve patients with moderate-to-
severe CD
#منقول#تعال_استفيد
