ECCO Guidelines on Therapeutics in Crohn's Disease: Medical Treatment

Crohn’s disease CD is a chronic inflammatory bowel disease IBD that can result in progressive bowel damage and disability1. CD can affect individuals of any age, from children to the elderly, 2, 3 and may cause significant morbidity and impact on quality of life. Up to one-third of patients present with complicated behaviour strictures, fistula, or abscesses at diagnosis4. Most patients over time will develop a complication, with roughly 50% of patients requiring surgery within 10 years of diagnosis5-7. As the precise aetiology of CD remains unknown, a curative therapy is not yet available8. Several agents are available for the medical treatment of CD. Medical agents include mesalazine 5-ASA, locally active steroids such as budesonide, systemic steroids, thiopurines such as azathioprine AZA and mercaptopurine MP, methotrexate MTX, and biological therapies such as anti-TNF, anti-integrins, and anti-IL12/23. European Crohn’s and Colitis Organisation ECCO produces and regularly updates several guidelines aimed at providing evidence-based guidance on critical aspects of IBD care to all healthcare professionals who manage patients with IBD. To provide high-quality evidence-based recommendations on medical and surgical treatment in CD, ECCO decided to develop these guidelines by adopting the GRADE Grading of Recommendations Assessment, Development, and Evaluation approach9. GRADE is a systematic process for developing guidelines that addresses how to frame the healthcare questions, summarize the evidence,. .