Gastroenterol Rep (Oxf). 2022 Nov 8;10:goac061. doi: 10.1093/gastro/goac061.eCollection 2022.

Jeffery M Venner ^1 2, Charles N Bernstein ^1 2

Author information

¹University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada.

²Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

Abstract

Immunomodulators, particularly the thiopurines and to a lesser extent methotrexate, were standard of care for inflammatory bowel diseases, including Crohn's disease and ulcerative colitis, for >40 years. While there has been a renaissance in available therapies with the advent of biologics and small molecules, an impetus remains for the ongoing use of thiopurines and methotrexate. This is particularly true for the maintenance of remission and when used in combination therapy with infliximab to suppress anti-biologic antibodies. This article summarizes the data behind immunomodulator use in Crohn's disease, focusing on the beneficial role these drugs still have while acknowledging their clinical limitations.