When are immune modifying agents indicated in the treatment of inflammatory bowel disease (IBD)?

Updated: Apr 10, 2020
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Answer

The immune-modifying agents are used if corticosteroids fail or are required for prolonged periods for milder disease; they can be used up front for moderate and severe disease. Anti-TNF monoclonal antibody therapies are also effective in both Crohn disease and ulcerative colitis; some studies have demonstrated that they have a greater efficacy than azathioprine. Historically, anti-TNF agents have been administered when Crohn disease has been unresponsive to steroids and immunosuppressants; however, the early introduction of these agents in conjunction with immunosuppressants in those with an increased risk of a complicated, severe, or possibly aggressive IBD has the potential to modify the disease course and is commonly pursued. [76]


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