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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
Some physicians limit B12 shots only to those with documented deficiencies or absorption issues to prevent unnecessary treatment where dietary B12 is sufficient
A Day in the life of a phlebotomist highlights the diverse conditions phlebotomists work under