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Emerging issues in the medical management of Crohn's disease

Targownik, Laura E.; Coneys, J. Gerard; Dhillon, Amit S.

Current Opinion in Gastroenterology: March 2016 - Volume 32 - Issue 2 - p 103–109
doi: 10.1097/MOG.0000000000000242
SMALL INTESTINE: Edited by Fergus Shanahan
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Purpose of review This article describes why this review is timely and relevant. The medical management of Crohn's disease is complex, and is changing rapidly with the introduction of novel therapeutic agents and management strategies.

Recent findings We have summarized and synthesized up-to-date evidence and opinion on the proper role and composition of combined immunosuppressive therapy in the management of Crohn's disease, the optimal time for introduction of immunomodulator and/or biologic therapies, and the benefits of therapeutic drug monitoring for biologic therapies. We also discuss the evidence supporting the benefits of the novel agents vedolizumab and ustekinumab, and discuss where they will fit into the therapeutic landscape.

Summary The review will provide evidence to support decision making in patients with Crohn's disease requiring biologic and/or immunomodulator therapy.

Section of Gastroenterology, Division of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

Correspondence to Laura E. Targownik, MD, MSHS, Section of Gastroenterology, Division of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Manitoba, 805G-715 McDermot Avenue Winnipeg, MB R3E 3P4, Canada. Tel: +1 204 789 3567; e-mail: laura.targownik@med.umanitoba.ca

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