Safety of treatments for inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD).
Inflammatory bowel diseases are chronic conditions of unknown etiology, showing a growing incidence and prevalence in several countries, including Italy. Although the etiology of Crohn's disease and ulcerative colitis is unknown, due to the current knowledge regarding their pathogenesis, effective treatment strategies have been developed. Several guidelines are available regarding the efficacy and safety of available drug treatments for inflammatory bowel diseases. Nevertheless, national guidelines provide additional information adapted to local feasibility, costs and legal issues related to the use of the same drugs. These observations prompted the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) to establish Italian guidelines on the safety of currently available treatments for Crohn's disease and ulcerative colitis. These guidelines discuss the use of aminosalicylates, systemic and low bioavailability corticosteroids, antibiotics (metronidazole, ciprofloxacin, rifaximin), thiopurines, methotrexate, cyclosporine A, TNFα antagonists, vedolizumab, and combination therapies. These guidelines are based on current knowledge derived from evidence-based medicine coupled with clinical experience of a national working group.
Gastroenterology Unit, University of Rome "Tor Vergata", Department of Systems Medicine, Rome, Italy. Electronic address: biancone@med.uniroma2.it.
Livia
L
Biancone
AOU Careggi, Gastroenterology, Florence, Italy.
Vito
V
Annese
Gastrointestinal Unit, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy.
Sandro
S
Ardizzone
IBD Unit, Presidio Columbus, Fondazione Policlinico Gemelli Universita' Cattolica, Rome, Italy.
Alessandro
A
Armuzzi
Gastroenterology Unit, University of Rome "Tor Vergata", Department of Systems Medicine, Rome, Italy.
Emma
E
Calabrese
Department of Pathophysiology and Transplantation, University of Milan and Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda,Ospedale Policlinico di Milano, Milan, Italy.
Flavio
F
Caprioli
Gastroenterology Unit, University 'Federico II', Naples, Italy.
Fabiana
F
Castiglione
Department of Gastroenterology and Digestive Endoscopy, Central Hospital, Bolzano, Italy.
Michele
M
Comberlato
Division of Internal Medicine 2, IBD Unit, Hospital "Riuniti Villa Sofia-Cervello", Palermo, Italy.
Mario
M
Cottone
Humanitas Research Hospital and Humanitas University, Rozzano (Milan), Italy.
Silvio
S
Danese
Hospital "Ordine Mauriziano di Torino", Turin, Italy.
Marco
M
Daperno
Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Italy.
Renata
R
D'Incà
University of L'Aquila, Gastroenterology Unit, L'Aquila, Italy.
Giuseppe
G
Frieri
Department of Clinical and Experimental Medicine, Clinical Unit for Chroric Bowel Disorders, University of Messina, Messina, Italy.
Walter
W
Fries
IBD Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Paolo
P
Gionchetti
San Camillo-Forlanini Hospital, IBD Unit, Rome, Italy.
Anna
A
Kohn
University of L'Aquila, Gastroenterology Unit, L'Aquila, Italy.
Giovanni
G
Latella
AOU Careggi, Gastroenterology, Florence, Italy.
Monica
M
Milla
Division of Internal Medicine 2, IBD Unit, Hospital "Riuniti Villa Sofia-Cervello", Palermo, Italy.
Ambrogio
A
Orlando
IBD Unit, San Filippo Neri Hospital, Rome, Italy.
Claudio
C
Papi
Gastroenterology Unit, University of Rome "Tor Vergata", Department of Systems Medicine, Rome, Italy.
Carmelina
C
Petruzziello
U.O. of Gastroenterology C.S. - University della Campania "Luigi Vanvitelli", Naples, Italy.
Gabriele
G
Riegler
IBD Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Fernando
F
Rizzello
Gastroenterology Unit, Rho Hospital, ASST Rhodense, Rho, Italy.
Simone
S
Saibeni
San Camillo-Forlanini Hospital, IBD Unit, Rome, Italy.
Maria Lia
ML
Scribano
Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato and University of Milan, San Donato Milanese, Milan, Italy.
Maurizio
M
Vecchi
Gastroenterology Unit, Sapienza, University of Rome, Rome, Italy.
Piero
P
Vernia
San Giuseppe Hospital, Gastroenterology, Milan, Italy.
Gianmichele
G
Meucci
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D010131:Aminosalicylic Acid / Q000009:adverse effects / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D007558:Italy; D015122:Mercaptopurine / Q000009:adverse effects / Q000627:therapeutic use; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D010131:Aminosalicylic Acid; D016572:Cyclosporine; C543529:vedolizumab; D015122:Mercaptopurine; D008727:Methotrexate
Guidelines; Inflammatory bowel disease; Medical treatments; Safety