Evidence-based treatment algorithm for mild to moderate Crohn's disease

Therapies demonstrated to be effective in randomized, controlled trials for induction of remission in patients with mildly to moderately active Crohn's disease include sulfasalazine, budesonide, and oral corticosteroids administered for 8-16 wk. Patients who relapse within 6-12 months after discontinuation of induction therapy should be treated with another cycle of induction therapy and then receive maintenance therapy with an immunosuppressive agent (azathioprine, 6-mercaptopurine, or methotrexate). Long term treatment with budesonide 6-9 mg q.d. might be an alternative to immunosuppressive maintenance therapy in patients who relapse within 6-12 months after discontinuation and in prednisone-dependent patients.