Korean clinical practice guidelines on biologics for moderate to severe Crohn's disease
Seong-Joon Koh1, Sung Noh Hong2, Soo-Kyung Park3
1Department of Internal Medicine, Liver Research Institute and Seoul National University College of Medicine, Seoul, Korea.
Insights
New Korean guidelines offer updated recommendations for managing moderate-to-severe Crohn's disease (CD) using advanced biologic agents. These guidelines reflect significant progress in understanding CD pathophysiology and treatment options.
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) with significant morbidity.
- Previous guidelines for CD management in Korea were published in 2012 and revised in 2017.
- Advances in mucosal immunology have driven the development of targeted biologic therapies.
Purpose of the Study:
- To provide updated recommendations for the management of moderate-to-severe Crohn's disease.
- To incorporate recent advancements in biologic therapies into clinical practice guidelines.
- To guide healthcare professionals in utilizing novel treatments for Crohn's disease.
Main Methods:
- Review of current scientific literature on Crohn's disease pathophysiology and treatment.
- Analysis of efficacy and safety data for biologic agents in moderate-to-severe CD.
- Consensus-based guideline development by the Inflammatory Bowel Disease (IBD) Research Group.
Main Results:
- Biologic agents, including tumor necrosis factor-α inhibitors, vedolizumab, and ustekinumab, are effective for induction and maintenance of remission in CD.
- CT-P13, an infliximab biosimilar, demonstrated non-inferiority to infliximab.
- Updated treatment algorithms emphasize the role of biologics in managing moderate-to-severe CD.
Conclusions:
- The third Korean guidelines provide evidence-based recommendations for biologic therapy in Crohn's disease.
- These guidelines aim to optimize treatment outcomes for patients with moderate-to-severe CD.
- Continued research and guideline updates are crucial for advancing CD management.
Abstract:
Crohn's disease (CD) is a relapsing and progressive condition characterized by diarrhea, abdominal pain, weight loss, and hematochezia that results in serious complications such as perforations, fistulas, and abscesses. Various medications, interventions, and surgical treatments have been used to treat CD. The Korean guidelines for CD management were distributed in 2012 and revised in 2017 by the Inflammatory Bowel Disease (IBD) Research Group of the Korean Association for the Study of Intestinal Diseases. Substantial progress in mucosal immunologic research has elucidated the pathophysiology of IBD, leading to development of biological agents for treatment of CD. The first developed biologic agent, tumor necrosis factor-α agents, were shown to be efficacious in CD, heralding a new era in management of CD. Subsequently, vedolizumab, a monoclonal antibody against integrin α4β7, and ustekinumab, a human monoclonal antibody that inhibits the common p40 subunit of interleukin-12 and interleukin-23, were both approved for clinical use and are efficacious and safe for both induction and maintenance of remission in moderate-to-severe CD patients. Moreover, a recent study showed the non-inferiority of CT-P13, an infliximab biosimilar, compared with infliximab in CD patients. The third Korean guidelines for CD management provide updated information regarding treatment of moderate-to-severe CD patients with biologic agents.
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