7
Recommendations
a
Recommendation Statements
Strength of
Recommendation
Certainty
of Evidence
8A. In adult outpatients with moderate to
severe CD, the AGA suggests the use
of corticosteroids over no treatment for
induction of remission.
Conditional Moderate
8B. In adult outpatients with moderate to severe
CD, the AGA recommends against the use
of corticosteroids over no treatment for
maintenance of remission.
Strong Moderate
9. In adult outpatients with moderate to severe
CD, the AGA recommends against the use
of 5-aminosalicylates or sulfasalazine over no
treatment for the induction or maintenance
of remission.
Strong Moderate
10A. In adult outpatients with CD and active
perianal fistula, the AGA recommends
the use of infliximab over no treatment for
the induction and maintenance of fistula
remission.
Strong Moderate
10B. In adult outpatients with CD and active
perianal fistula, the AGA suggests the use of
adalimumab, ustekinumab, or vedolizumab
over no treatment for the induction or
maintenance of fistula remission.
Comment: Evidence suggests certolizumab
pegol may not be effective for induction of
fistula remission.
Conditional Low
10C. In adult outpatients with CD and active
perianal fistula without perianal abscess, the
AGA suggests against the use of antibiotics
alone over no treatment for the induction of
fistula remission.
Conditional Low
11. In adult outpatients with CD and active
perianal fistula without perianal abscess,
the AGA recommends the use of biologic
agents in combination with an antibiotic
over a biologic drug alone for the induction
of fistula remission.
Strong Moderate
a
Please see the technical review for the supporting evidence [https://www.gastrojournal.org/article/
S0016-5085(21)00646-6/fulltext]
