Overview of pharmacotherapy for Crohn disease [13][20]
Indication
Substance class
Symptomatic treatment
Mild-tomoderate disease
Moderate-tosevere disease
Acute
episode
Severe/fulminant
disease
Steroidrefractory disease
Maintenance therapy
Substances

Antidiarrheal agents


Loperamide
Bile acid binders

Topical corticosteroids

Triamcinolone

Topical 5-aminosalicylic acid derivatives (5-ASAs) (e.g., suppository, foam, enema)

Topical corticosteroids

Oral budesonide

Sulfonamides

Sulfasalazine

First-line: oral corticosteroids

Prednisone

Steroid-sparing: thiopurine analogs


Azathioprine
6-Mercaptopurine

Alternatively
o Anti-p40 antibodies
o Alpha 4 integrin inhibitors


Ustekinumab (anti-p40 antibody)
Natalizumab, vedolizumab (alpha
4 integrin inhibitors)

First-line: IV corticosteroids

Methylprednisolone

Infliximab, adalimumab, certolizumab (TNFα antibodies)
If necessary: azathioprine (or 6mercaptopurine)


First-line: TNF-α antibodies, if necessary
in combination with thiopurine analogs
Choice of substance depends on which agent
was used to induce remission


Azathioprine, 6-mercaptopurine (thiopurine
analogs)
Overview of pharmacotherapy for Crohn disease [13][20]
Indication
Substance class



Corticosteroids are contraindicated for
maintenance.
5-ASA/sulfasalazine have proven to be
inefficient. [21]
The following substance classes are available:
o Thiopurine analogs
o Antimetabolites
o TNF-α antibodies
o Anti-p40 antibody
o Alpha 4 integrin inhibitors
Substances




Methotrexate (antimetabolite)
Infliximab, adalimumab, certolizumab (TNFα antibodies)
Ustekinumab (anti-p40 antibody)
Natalizumab, vedolizumab (alpha
4 integrin inhibitors)