title: Emerging issues in the medical management of Crohn's disease.
abstract: OBJECTIVE
  This article describes why this review is timely and relevant. The medical management of Crohn's disease is complex, and is changing rapidly with the introduction of novel therapeutic agents and management strategies.
  
  
  RESULTS
  We have summarized and synthesized up-to-date evidence and opinion on the proper role and composition of combined immunosuppressive therapy in the management of Crohn's disease, the optimal time for introduction of immunomodulator and/or biologic therapies, and the benefits of therapeutic drug monitoring for biologic therapies. We also discuss the evidence supporting the benefits of the novel agents vedolizumab and ustekinumab, and discuss where they will fit into the therapeutic landscape.
  
  
  CONCLUSIONS
  The review will provide evidence to support decision making in patients with Crohn's disease requiring biologic and/or immunomodulator therapy.
authors.affiliation: Section of Gastroenterology, Division of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Targownik
authors.forename: J Gerard
authors.initials: JG
authors.lastname: Coneys
authors.forename: Amit S
authors.initials: AS
authors.lastname: Dhillon
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000627:therapeutic use*; D000069549:Ustekinumab / Q000627:therapeutic use*
chemical_list: D000891:Anti-Infective Agents, Local; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; C543529:vedolizumab; D000069549:Ustekinumab