Sequencing of Pharmacological Management of Crohn’s Disease and Ulcerative Colitis: A Review of Guidelines


Project Line:
Health Technology Review
Project Sub Line:
Summary with Critical Appraisal
Project Number:


  1. What are the evidence-based guidelines associated with the early use of biologics in the sequencing of pharmacological treatments for patients with moderate to severe Crohn’s disease or ulcerative colitis?

Key Message

The evidence-based guidelines from Canadian Association of Gastroenterology recommended that for patients with perianal fistulizing Crohn’s disease, anti-TNF such as infliximab or adalimumab should be used as initial treatment, possibly combined with thiopurine or methotrexate. The guideline stated that the recommendation was based on evidence of very low quality.