Crohn's disease
ICD-10 K50 · ICD-11 DD70

Treatment of Moderate-to-Severely Active Crohn's Disease in Patients Naive to Advanced Therapies

This protocol applies to adult outpatients with moderate-to-severely active Crohn's disease who have not previously received any advanced therapy. Both disease severity and the absence of prior advanced treatment directly inform the recommended treatment strategy.

Clinical Scenario

Moderate-to-severely active Crohn's disease in adults with no prior exposure to advanced therapies. Therapy-naive status is a defining feature of this population and shapes which treatments are appropriate to initiate.

Clinical Target

Induction and maintenance of clinical remission, defined as a Crohn's Disease Activity Index (CDAI) below 150.

Treatment Approach (Partial Overview)

Current evidence-based guidance prioritizes initiating a higher-efficacy advanced therapy over a lower-efficacy alternative as the first treatment step. Several higher-efficacy options are considered interchangeable at this stage. Full agent selection, preferred options, and the complete evidence-based regimen are available in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

  1. In adult outpatients with moderate-to-severely active CD who are naïve to advanced therapies, the AGA suggests using a HIGHER efficacy medication (infliximab, adalimumab, vedolizumab, ustekinumab, risankizumab, mirikizumab, guselkumab), rather than a LOWER efficacy medication (certolizumab pegol, upadacitinib).
  2. CDAI scores <150 suggest clinical remission, and scores 150–220, 221–450, and >450 denote mild, moderate, and severe disease, respectively.
View source ↗