AGA Recommendations for Crohn’s Disease Treatment

Anti TNF medications and thiopurines work well for Crohns disease treatment according to the AGA

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) The American Gastroenterological Association (AGA) released its official recommendations for the treatment of Crohn’s disease — an inflammatory disease of the digestive tract.

The report lists several recommendations to provide relief from the symptoms of Crohn’s disease, which can include abdominal pain and fatigue.

One recommendation involved combining a thiopurine — a slower acting medication that reduces inflammation — with an anti-tumor necrosis factor (TNF) medication, which does the same thing but works faster.

"Speak with your doctor about appropriate treatment options for Crohn’s disease."

This report was led by Jonathan P. Terdiman, MD, in the Division of Gastroenterology at the University of California, San Francisco School of Medicine. The report committee developed recommendations to help physicians create effective treatment plans for their patients.

Dr. Terdiman and colleagues gave several recommendations for physicians and patients to help patients with moderately severe Crohn’s disease enter and stay in remission (a period where patients experience no symptoms from their disease). The recommendations were classified as strong or weak based on the strength of the evidence to support them.

Some of the strong recommendations included the following:

  • Use an anti-tumor necrosis factor (TNF) medication to help patients enter into remission. In people with Crohn’s disease, the immune system begins to attack cells of the small intestine which causes inflammation. Anti-TNF medications work to reduce inflammation.
  • Use an anti-TNF medication in combination with thiopurines to help patients enter into remission. Thiopurines are another class of medications that reduce inflammation, but they work slower than anti-TNF medications.

Some of the weak recommendations include the following:

  • Use thiopurines in combination with an anti-tumor necrosis factor (TNF) medication or a systemic corticosteroid to help provide faster relief from symptoms. Systemic corticosteroids work to reduce inflammation faster than thiopurines as well.
  • Do not use methotrexate to enter remission. Methotrexate is another medication used to treat Crohn’s disease and based on two studies, the authors found it to be no more effective in helping patients enter remission than a placebo (a fake pill).

The authors concluded that more studies are needed to help inform future recommendations about the successful treatment of Crohn’s disease.

The report was published on December 17 in Gastroenterology.

One of the authors of this report disclosed potential conflicts of interest with companies including Shire and Centocor.

Review Date: 
December 24, 2013
Last Updated:
December 26, 2013