hospitalization required Maintenance of Remission: Immunomodulators (azathioprine, 6-MP, methotrexate) for steroid-dependent or frequently-relapsing disease Biologic monotherapy or combination therapy (biologic + immunomodulator) for moderate-to-severe disease Step-up or top-down approach based on disease severity, patient risk factors, and prior therapy Biologic Therapy Targets: TNF-: Infliximab (IV), adalimumab (SC), certolizumab pegol (SC) IL-12/23: Ustekinumab (IV induction, SC maintenance) Integrin: Vedolizumab (IV) IL-23: Risankizumab (IV induction, SC maintenance) JAK inhibition: Upadacitinib (oral) Surgical Management Surgery is indicated in approximately 7080% of patients with Crohns disease over their lifetime, per StatPearls
Compounded medications like MIC+B12 are prescribed individually and not mass-produced, so they are not reviewed by the FDA
Those pregnant, breastfeeding, or undergoing cancer treatment should avoid it until more data becomes available
However, it should always be used under the supervision of a physician to ensure appropriate dosage and duration of use
Kwon, D
