Management Algorithm
a
Surgically-induced CD remission
No pharmacological
prophylaxis
a
ough most clinical trials in postoperative CD have evaluated only monotherapy, combination
therapy may improve efficacy and decrease immunogenicity based on indirect evidence from trials
of luminal CD.
b
iopurine monotherapy may be appropriate for lower risk patients with i2 recurrence.
Ileocolonoscopy at
6–12 months
Pharmacological
prophylaxis
anti-TNF and/or
thiopurine
b
± nitroimidazole
(3 months)
Nitroimidazole
antibiotic
(3 months)
Low risk of
recurrence or patient
preference/values
Patient preference or
intolerance to anti-
TNF and thiopurine
Ileocolonoscopy at
6–12 months
Endoscopic
recurrence
(Rutgeerts ≥i2)
Endoscopic
recurrence
(Rutgeerts ≥i2)
Optimize or add
thiopurine/anti-TNF
Anti-TNF and/or
thiopurine
b
