IBD Treatment: The Basics

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Presentation transcript:

IBD Treatment: The Basics Megan Chan, PGY2 UHCMC

5-ASA (Amino salicylic acid) Uses: Induction/Maintenance of UC Very mild CD Formulations: Sulfasalazine = 5ASA + Sulfa Mesalamine = 5ASA in pH sensitive or time-dependent capsules Pentasa—time released duodenum to colon Asacol—pH released in TI & colon Lialda—pH released in TI & colon Canasa = suppository (effective to 10-15 cm) Rowasa = enema (effective to splenic flexure)

Steriods Uses: Induction of UC & Crohn’s Topical: IV: PO: NOT for maintenance, fistulizing/stricturing Crohn’s Topical: Cortifoam/Cortenema—best for proctitis & proctosigmoiditis Budesondie (Entocort)—oral  pH released in TI & right colon IV: Solumedrol 20mg q8hrs Hydrocortisone 100mg q8hrs PO: Prednisone 40-60mg with taper over 1-2 months

Biologics (Anti-TNF) Infliximab (Remicade)—Crohn’s & UC Adalimumab (Humira)--Crohn’s & UC Certolizumab (Cimzia)—Crohn’s Golimumab (Simponi)—UC

Immunomodulators Azathioprine (Imuran) 6MP (Purinethol) Methotrexate (MTX) Cyclosporine (Neoral) *In combination with biologics, these can decrease Ab formation

Leukocyte Trafficking Agents Natalizumab (Tysabri)—Crohn’s Vedolizumab (Entyvio)—UC > Crohn’s

Antibiotics Useful in perianal and fistulizing Crohn’s Flagyl 750-1000mg/day Cipro 1000mg/day

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