Positioning Therapies in the Management of Crohn's Disease

Nghia H Nguyen; Siddharth Singh; William J Sandborn

doi:10.1016/j.cgh.2019.10.035

Positioning Therapies in the Management of Crohn's Disease

Clin Gastroenterol Hepatol. 2020 May;18(6):1268-1279. doi: 10.1016/j.cgh.2019.10.035. Epub 2019 Oct 30.

Authors

Nghia H Nguyen¹, Siddharth Singh², William J Sandborn³

Affiliations

¹ Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California.
² Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California; Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California.
³ Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California. Electronic address: wsandborn@ucsd.edu.

Abstract

In the past decade, several new therapies with different mechanisms of action have been approved for the management of moderate to severe Crohn's disease. However, there is limited guidance on optimal positioning of agents as first- or second-line therapies because of the absence of head-to-head trials. Furthermore, given the lack of comparative studies, treatment guidelines have provided limited insight. In this review, we discuss data on key treatment attributes, comparative efficacy and safety, factors predictive of response to each agent, and propose an algorithm for positioning therapies for the management of patients with low-risk and high-risk Crohn's disease.

Keywords: Biologics; Crohn's; IBD; Therapies; Treatment.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Crohn Disease* / therapy
Disease Management
Humans
Risk Assessment

Abstract

Publication types

MeSH terms

Grants and funding