Safety of treatments for inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD)

• Published in: Digestive and liver disease Vol. 49; no. 4; pp. 338 - 358
• Main Authors: Biancone, Livia, Annese, Vito, Ardizzone, Sandro, Armuzzi, Alessandro, Calabrese, Emma, Caprioli, Flavio, Castiglione, Fabiana, Comberlato, Michele, Cottone, Mario, Danese, Silvio, Daperno, Marco, D’Incà, Renata, Frieri, Giuseppe, Fries, Walter, Gionchetti, Paolo, Kohn, Anna, Latella, Giovanni, Milla, Monica, Orlando, Ambrogio, Papi, Claudio, Petruzziello, Carmelina, Riegler, Gabriele, Rizzello, Fernando, Saibeni, Simone, Scribano, Maria Lia, Vecchi, Maurizio, Vernia, Piero, Meucci, Gianmichele, Rugge, Massimo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-04-2017
• Subjects: Adrenal Cortex Hormones - adverse effects; Adrenal Cortex Hormones - therapeutic use; Aminosalicylic Acid - adverse effects; Aminosalicylic Acid - therapeutic use; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Cyclosporine - adverse effects; Cyclosporine - therapeutic use; Drug Therapy, Combination; Evidence-Based Medicine; Female; Gastroenterology and Hepatology; Guidelines; Humans; Inflammatory bowel disease; Inflammatory Bowel Diseases - drug therapy; Italy; Medical treatments; Mercaptopurine - adverse effects; Mercaptopurine - therapeutic use; Methotrexate - adverse effects; Methotrexate - therapeutic use; Pregnancy; Randomized Controlled Trials as Topic; Safety; Treatment Outcome; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Inflammatory bowel disease; Safety; Medical treatments; Guidelines
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2017.01.141

Abstract Inflammatory bowel diseases are chronic conditions of unknown etiology, showing a growing incidence and prevalence in several countries, including Italy. Although the etiology of Crohn’s disease and ulcerative colitis is unknown, due to the current knowledge regarding their pathogenesis, effective treatment strategies have been developed. Several guidelines are available regarding the efficacy and safety of available drug treatments for inflammatory bowel diseases. Nevertheless, national guidelines provide additional information adapted to local feasibility, costs and legal issues related to the use of the same drugs. These observations prompted the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) to establish Italian guidelines on the safety of currently available treatments for Crohn’s disease and ulcerative colitis. These guidelines discuss the use of aminosalicylates, systemic and low bioavailability corticosteroids, antibiotics (metronidazole, ciprofloxacin, rifaximin), thiopurines, methotrexate, cyclosporine A, TNFα antagonists, vedolizumab, and combination therapies. These guidelines are based on current knowledge derived from evidence-based medicine coupled with clinical experience of a national working group.