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First-Line Therapies in Inflammatory Bowel Disease

Girardin M.a · Manz M.b · Manser C.c · Biedermann L.c · Wanner R.c · Frei P.c · Safroneeva E.d · Mottet C.e, f · Rogler G.c · Schoepfer A.M.e
aDivision of Gastroenterology and Hepatology, University Hospital Geneva, Geneva, bDivision of Gastroenterology and Hepatology, Claraspital, Basel, cDivision of Gastroenterology and Hepatology, University Hospital of Zurich, Zurich, dInstitute of Social and Preventive Medicine, University of Berne, Berne, eDivision of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, Lausanne, and fDivision of Gastroenterology and Hepatology, Hôpital de Neuchâtel, Neuchâtel, Switzerland Digestion 2012;86(suppl 1):6–10 (DOI:10.1159/000341951)


Background and Aims: Medical therapy of inflammatory bowel disease (IBD) is becoming more complex, given the increasing choice of drugs to treat Crohn’s disease (CD) and ulcerative colitis (UC). We aimed to summarize the current guidelines for first-line treatments in IBD. Methods: An extensive literature search with focus on the guidelines of the European Crohn’s and Colitis Organisation for the diagnosis and treatment of CD and UC was performed. First-line treatments were defined as the following drug categories: 5-aminosalicylates, budesonide, systemic steroids, azathioprine, 6-mercaptopurine, methotrexate, infliximab, adalimumab and certolizumab pegol. The following drug categories were not included: cyclosporine and tacrolimus (not yet approved by Swissmedic for IBD treatment). Results: Treatment recommendations for the following clinically frequent situations are presented according to disease severity: ileocecal CD, colonic CD, proximal small bowel CD and perianal CD. For UC the following situations are presented: ulcerative proctitis, left-sided colitis and pancolitis. Conclusions: We provide a summary on the use of first-line therapies for clinically frequent situations in patients with CD and UC.


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