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. 2024 Sep 3;16(9):e68569. doi: 10.7759/cureus.68569

Table 3. Medications for the management of Crohn's disease.

CD: Crohn's disease

Disease severity Medications  Reference
Induction of remission Maintenance
Mild to moderate Oral corticosteroids. Consider enteral nutritional therapy. Consider the use of sulfasalazine if there are lesions in the colon. TNF inhibitors are recommended to be considered for steroid-dependent or refractory patients. Asymptomatic patients and/or those with a low risk of CD progression: Provide supportive therapy as needed. Patients at high risk of CD progression or with ongoing inflammation: Consider using anti-TNF-alpha therapy. [106,107]
Moderate to severe Oral corticosteroids. Consider enteral nutritional therapy. TNF inhibitors are recommended to be considered for steroid-dependent or refractory patients. If pharmacotherapy or nutrition therapy is ineffective or unable to adapt, the combination with granulocyte monocyte apheresis (GMA) can be considered. Gradually reduce and then discontinue corticosteroids. Maintain the use of non-steroidal agents that achieved remission. Combination therapy with anti-TNF-α antibodies and an immunomodulator is preferred over using monotherapy. [106,107]
Severe to fulminant It is recommended that patients be hospitalized, given infusions and blood transfusions if needed, and administered antibiotics if infection is suspected. Systemic Corticosteroids (if no active infection). TNF inhibitors are recommended to be considered for steroid-dependent or refractory patients. Seek early surgical consultation for patients in poor general condition who do not respond to anti-TNF agents.