Treatment
10
Figure 2. Medical Management of Adult Outpatients With
Moderate to Severe Fistulizing Crohn's Disease
• Recommend the use of biologic agents in combination
with an antibiotic over a biologic drug alone for the
induction of fistula remission
(strong, moderate)
Biologic therapy
• Recommend infliximab over
no treatment for induction and
maintenance of fistula remission
(strong, moderate)
• Suggest adalimumab,
ustekinumab, or vedolizumab
over no treatment for induction
and maintenance of fistula
remission
(conditional, low)
Comment: Evidence suggest
certolizumab pegol may not be
effective for induction of fistula
remission.
Adult outpatients with active perianal disease
without perianal abscess
• Suggest AGAINST the use
of antibiotics alone over no
treatment for the induction of
fistula remission
(conditional, low)
Antibiotics
