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Luminal and Fistulizing Crohn’s Disease - Moderate-Severe

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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

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