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Mild to Moderate Crohn's Disease

An Evidence-Based Treatment Algorithm

  • Therapy in Practice
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Abstract

Crohn's disease is a chronic inflammatory condition with a relapsing-remitting disease course. Treatment often requires both induction and maintenance strategies. The management of mild to moderate Crohn's disease is challenging because the natural history of mild disease is not known and effective treatment options are limited. In this article, our objective is to provide a brief overview of the evidence supporting current therapies in the treatment of mild to moderate luminal Crohn's disease and to explore a few of the newer therapeutic options.

As induction agents for mild to moderately active Crohn's disease, there is reasonable evidence to support the use of budesonide for terminal ileal and right colonic disease, and sulfasalazine for colonic disease. Although budesonide can be used in the short term (3–6 months) for maintenance of quiescent disease, there are no effective therapies for the long-term maintenance of mild to moderate Crohn's disease. Mesalazine appears to have no role in either the treatment of active or quiescent disease. Currently, there is insufficient data to draw conclusions on the potential role of antibacterials, probiotics or prebiotics.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. Dr Bressler has received speaker’s fees and honoraria for participation on an advisory board from Shire. Dr Wong has no conflicts of interest that are directly relevant to the content of this review.

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Authors and Affiliations

  1. Division of Gastroenterology, University of British Columbia, Suite 770, 1190 Hornby Street, Vancouver, British Columbia, V6Z 2K5, Canada

    Karen Wong &  Brian Bressler

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  1. Karen Wong
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  2. Brian Bressler
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Correspondence to Brian Bressler.

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Wong, K., Bressler, B. Mild to Moderate Crohn's Disease. Drugs 68, 2419–2425 (2008). https://doi.org/10.2165/0003495-200868170-00002

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