Table 1.
| Class | Drug | Disease | Dose | ||
|---|---|---|---|---|---|
| Induction | Maintenance | Dose Optimization |
|||
| Aminosalicylates [26,28,30] | Sulfasalazine | UC | ≥3 g/d | ≥2 g/d | - |
| 5-ASA | UC | Distal colitis: rectal 5-ASA ≥ 1 g/d Extensive colitis: rectal 5-ASA ≥ 1 g/d + oral 5-ASA ≥ 2 g/d |
≥1 g/d >2 g/d |
- >4 g/d |
|
| Glucocorticoids [26,27,28,29,31,32] | Prednisolone | CD, UC | 0.5–0.75 mg/kg (maximum daily dose 60 mg) | - | - |
| Budesonide | CD | 9 mg/day 2–3 months | - | - | |
| Budesonide MMX | UC | 9 mg/day 2–3 months | - | - | |
| Immunomodulators [26,27,28,29,30,33] | Azathioprine | CD, UC | 1.5–2.5 mg/kg/d | - | |
| 6-Mercaptopurine | CD, UC | 1–1.5 mg/kg/d | - | ||
| Cyclosporine | UC | 2 mg/kg/d IV | 5 mg/kg/d (up to 3 months) | - | |
| Methotrexate | CD | 25 mg/w SC or IM (12w) | 15 mg/w SC or IM | - | |
| Anti-TNF | Infliximab [34,35,36,37] | CD, UC | 5 mg/kg IV at 0, 2 and 6 w | 5 mg/kg IV every 8w 120 mg SC every 2wfrom w6 |
10 mg/kg IV every 8w (label) or 5 mg/kg every 4w (off-label) |
| Adalimumab [38,39,40] | CD, UC | 160 mg, then 80 mg after 2w SC | 40 mg SC every 2w | 80 mg SC every 2w or 40 mg SC weekly | |
| Certolizumab pegol [41,42] | CD | 400 mg SC at weeks 0, 2 and 4 | 400 mg every 4w | - | |
| Golimumab [43,44] | UC | 200 mg, then 100 mg after 2w SC | 50–100 mg SC every 4w | <80 kg using 50 mg: 100 mg every 4w | |
| Anti-Integrin | Natalizumab [45] | CD | 300 mg IV every 4w | ||
| Vedolizumab [46,47,48] | CD, UC | 300 mg IV at weeks 0, 2 and 6. CD: an additional dose at w10 may be indicated | 300 mg IV every 8w 108 mg SC every 2w |
300 mg IV every 4w - |
|
| Anti-Interleukin | Ustekinumab [49,50] | CD, UC | <55 kg: 260 mg, 55–85 kg: 390 mg, >85 kg: 520 mg IV single dose. | 90 mg SC every 12 or 8w | 90 mg SC every 4w (off-label) |
| Risankizumab [51,52] | CD | 600 mg IV at weeks 0, 4 and 8 | 360 mg SC at w12 and then every 8w | - | |
| Mirikizumab * [53] | UC | 300 mg IV every 4w for 12w | 200 mg IV every 4w | ||
| JAK-inhibitors | Tofacitinib [54] | UC | 10 mg BID PO 8–12w | 5 mg PO BID | In loss of response, consider new induction |
| Filgotinib [55] | UC | 200 mg PO OD 10w | 100–200 mg PO OD | - | |
| Upadacitinib [56,57] | CD, UC | UC: 45 mg PO OD 8w CD: 45 mg PO OD 12w | 15–30 mg PO OD | - | |
| S1p modulators | Ozanimod [58] | UC | Day 1–4: 0.92 mg PO Day 5–7: 0.46 mg PO | 0.92 mg PO | - |
| Etrasimod * [59] | UC | 2 mg PO OD | |||
Doses referring to the treatment of IBD in adults. * Doses used in phase 3 studies. 5-ASA: 5-aminosalicylates. MMX: multi-matrix system. PO: orally. SC: subcutaneous. IV: intravenous. D: day. W: week.