Crohn's Disease Treatment Update

Priyam Mithawala, PharmD

Disclosures

US Pharmacist. 2018;43(12):16-25. 

In This Article

Abstract and Introduction

Abstract

Inflammatory bowel disease (IBD) is an idiopathic inflammatory disorder with immunologic, genetic, and environmental influences of unknown etiology. IBD features two distinct diseases: Crohn's disease (CD) and ulcerative colitis. The prevalence of CD has consistently increased over the past several decades. In March 2018, the American College of Gastroenterology (ACG) released an updated guideline on managing CD in adult patients. It includes preferable approaches on diagnosis, disease modifiers, and medical therapy for the various disease severities. ACG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria to evaluate the level of evidence and rate recommendations.

Introduction

Inflammatory bowel disease (IBD) is an idiopathic inflammatory disorder of unknown etiology with immunologic, genetic, and environmental influences. IBD encompasses two distinct diseases: Crohn's disease (CD) and ulcerative colitis (UC).[1,2] CD involves any area of the gastrointestinal tract (GIT) from the oral cavity to the anus, but it is limited primarily to the colon with or without small-intestine disease. Moreover, the inflammation in CD is often described as transmural, damaging each mucosal layer of the GIT, and noncontinuous.[2] Therapy for CD includes medical therapy with pharmacologic agents consisting of 5-aminosalicylates (5-ASA), antibiotics, corticosteroids, immunomodulators, and biologics.[3] Surgery is reserved for patients who are refractory to medical therapy.

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