First-line therapies in inflammatory bowel disease.
OBJECTIVE
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.
Division of Gastroenterology and Hepatology, University Hospital Geneva, Geneva, Switzerland. marcgirardin @ gmail.com
Marc
M
Girardin
Michael
M
Manz
Christine
C
Manser
Luc
L
Biedermann
Roger
R
Wanner
Pascal
P
Frei
Ekaterina
E
Safroneeva
Christian
C
Mottet
Gerhard
G
Rogler
Alain M
AM
Schoepfer
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003092:Colitis / Q000188:drug therapy / Q000473:pathology; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000473:pathology; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007079:Ileitis / Q000188:drug therapy / Q000473:pathology; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index
D000893:Anti-Inflammatory Agents