Disease
Figure 6 (cont'd)
Perform treatment for patient not in remission
Low-risk patient
G
Mod/high-risk patient
I
Options:
• Immunosuppressive
• Assess drug levels
• Consider anti-TNF therapy
Options:
• Use anti-TNF monotherapy over no
therapy or thiopurine monotherapy
• Use anti-TNF + thiopurine over
thiopurine monotherapy or anti-TNF
monotherapy
Positive response Failure to respond
Low or undetectable
drug concentration
and low or undetectable
anti-drug
Low or undetectable
drug concentration
and high anti-drug
antibody
Therapeutic drug
concentration and
low or undetectable
anti-drug antibody
Increase drug dose
Switch within drug
class
Assess inflammation
Inflammation
present
Inflammation
not present
Switch to
another
drug class
Continue drug
at current dose
and look for
other causes
