AGA updates Crohn's disease treatment guidelines
The American Gastroenterological Association (AGA) has release new evidence based guidelines for treating Crohn's disease that are the first to make specific medication recommendations.
The recommendations were formed from a review of risks and benefits, clinical evidence and patient preferences.
"Crohn's disease is a lifelong, relapsing disorder that can damage the bowel and lead to multiple abdominal operations over time. Deciding which medications are the best is a common dilemma for gastroenterologists and the Crohn's patients we treat. The disease can be disabling, but the drugs to control the disease can be toxic too and they can be costly," said Jonathan P. Terdiman, MD, lead author of the guidelines, and Chief of the Gastroenterology Service at the University of California, San Francisco Medical Center. "The new AGA guideline and clinical decision support tool will ease the decision process by providing transparent and actionable recommendations," Terdiman adds.
Biological agents for Crohn's disease remission come first
The guidelines are as follows:
- For active cases of Crohn's disease that are moderately severe anti-TNF-α drugs are recommended. The drugs are biological agents that block activity of the immune system that leads to Crohn's and other diseases. Examples include Remicade and Enbrel that are perhaps the most popularly prescribed treatment for the inflammatory bowel disease (IBD).
- The guidelines also suggest anti-TNF-α drugs over thiopurines that are used to treat Crohn's disease when cases are moderately severe as a single therapy. Popular thiopurine examples include Azasan® and Imuran®.
- The groups suggests a combination of anti-TNF-α drugs and thiopurines could also be used for moderately severe Crohn's disease treatment.
For people whose Crohn's disease is in remission:
- Drugs like Imuran and Azasan that are called immunumodulators should supercede the use of anti-TNF -α agents once remission is achieved from steroids or the biological agents suggested above.
- The guidelines also advise against methotrexate for inducing remission of Crohn's disease that is moderately severe.
- Standard therapy should include mesalamine, antibiotics, steroids and immunumodulators
You can read the new guidelines for Crohn's disease treatment here.
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