IBD regimens Flashcards
For Mild distal UC, what is first line therapy?
Topical aminosalicylates (enema/suppository)
For mild distal UC, If first line therapy doesn’t work, what should you try next?
- Oral aminosalicylate
OR - Topical corticosteroids
For mild distal UC what can be used for remission/maintenance?
- Mesalamine (enema or suppository) 3x/week
- Oral aminosalicylate to maintenance dose
For mild EXTENSIVE UC, what is used as first line therapy?
- Oral aminosalicylate
OR - Oral budesonide
For mild EXTENSIVE UC, if there’s no response to the first line therapy, what should you use?
Oral corticosteriod
For mild DISTAL UC, what can be used for remission/maintenance?
Oral aminosalicylate at maintenance dose
For moderate severe UC, what is used as first line? Per ACG
- Oral aminosalicylate
OR - Oral budesonide
For moderate severe UC, what can you use second line per ACG?
Systemic corticosteroids
For moderate severe UC, what can be used as an alternative per ACG?
Biologics: adalimumab, golimumab, infliximab
For moderate severe UC, what is used as first line therapy per AGA?
Biologics: infliximab, golimumab, adalimumab, vedolizumab
What are additional therapies for moderate severe UC that can be used per AGA?
- Tofacitinib
- Ustekinumab
For moderate severe UC, you can consider combining what?
TNF inhibitor, vedolizumab or Ustekinumab with a thiopurine
What can be used for remission/maintenance for moderate severe UC?
- Oral aminosalicylate at maintenance dose (if responded)
- Thiopurine (if due to corticosteroid induction)
- TNF inhibitor or other biologic
For severe fulminant UC, what is used as first line therapy?
- IV corticosteroids
If a patient doesn’t respond to the first line therapy of severe fulminant UC, what can be used?
- Infliximab
OR - IV cyclosporine