AGA releases practical guideline on medical management of Crohn's disease

Written By : Hina Zahid |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-05-29T09:00:23+05:30 | Updated On 29 May 2021 9:00 AM IST

USA: The American Gastroenterological Association (AGA) has released new guidelines for the medical management of moderate to severe luminal and perianal fistulizing Crohn's disease. The guideline, published in the journal Gastroenterology, outlines the benefits and risk of each drug currently available to Crohn's patients.

For developing the guidelines, the researchers conducted a detailed review of available literature. Based on the research, AGA recommends the early introduction of biologics for patients experiencing luminal and fistulizing Crohn's disease rather than waiting until other treatments fail.

Crohn's disease, a type of inflammatory bowel disease (IBD) that causes inflammation (pain and swelling) in the gastrointestinal tract, can cause daily health problems, frequent hospitalizations, and surgery when not adequately controlled. While there is no cure for Crohn's disease, there are treatments that can help patients live symptom-free life.

"With many new drugs entering the market, clinician's ability to treat patients with Crohn's disease has improved greatly over the last 20 years," said lead author Joseph D. Feuerstein, MD, from Beth Israel Deaconess, Boston, Massachusetts. "We hope this new guideline serves as a manual for clinicians in selecting the right therapies for their patients, which should lead to improved patient outcomes and less need for invasive surgery."

Key guideline recommendations:

1. Biologics are the most effective drugs for the management of Crohn's and they should be used early, rather than delaying their use until after failure of mesalamine and/or corticosteroids, in patients with moderate to severe or fistulizing Crohn's disease. These drugs are antibodies and can more precisely target the immune system which is causing the inflammation in Crohn's disease.

a. Anti-tumor necrosis factor (anti-TNF) agents or ustekinumab are recommended and vedolizumab is suggested as a first-line treatment.

b. In patients who have previously not responded to anti-TNF agents, AGA recommends ustekinumab or vedolizumab.

c. The biologic natalizumab is no longer recommended due to potential adverse events and the availability of safer treatment options.

Reference:

"AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn's Disease," is published in the journal Gastroenterology.

DOI: https://www.gastrojournal.org/article/S0016-5085(21)00645-4/fulltext

inflammatory bowel diseaseCrohn diseasebiologicsjournal Gastroenterology

Source : Gastroenterology

Hina Zahid

Hina Zahid Joined Medical Dialogue in 2017 with a passion to work as a Reporter. She coordinates with various national and international journals and association and covers all the stories related to Medical guidelines, Medical Journals, rare medical surgeries as well as all the updates in the medical field. Email: editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751