ECCO Topical Review: Refractory Inflammatory Bowel Disease

Tim Raine¹, Bram Verstockt^{2

3}, Uri Kopylov^{4

5}, Konstantinos Karmiris⁶, Rimma Goldberg⁷, Raja Atreya⁸, Johan Burisch⁹, John Burke¹⁰, Pierre Ellul¹¹, Charlotte Hedin^{12

13}, Stefan D Holubar¹⁴, Konstantinos Katsanos¹⁵, Triana Lobaton¹⁶, Carsten Schmidt¹⁷, Garret Cullen¹⁸

Affiliations

¹ Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
² Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
³ Department of Chronic Diseases and Metabolism, TARGID - IBD, KU Leuven, Leuven, Belgium.
⁴ Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
⁵ Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
⁶ Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece.
⁷ Department of Gastroenterology, Monash Health and School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.
⁸ Department of Medicine 1, University of Erlangen-Nürnberg, Erlangen, Germany.
⁹ Gastrounit, Medical Division, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
¹⁰ Colorectal and General Surgery, Beaumont Hospital, Dublin, Ireland.
¹¹ Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta.
¹² Karolinska Institutet, Department of Medicine Solna, Stockholm, Sweden.
¹³ Karolinska University Hospital, Gastroenterology Unit, Department of Gastroenterology, Dermatovenereology and Rheumatology, Stockholm, Sweden.
¹⁴ Department of Colon & Rectal Surgery, Cleveland Clinic, Cleveland, OH, USA.
¹⁵ Department of Gastroenterology and Hepatology, University and Medical School of Ioannina, Ioannina, Greece.
¹⁶ Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium.
¹⁷ Medical Faculty of the Friedrich Schiller University, Jena, Germany.
¹⁸ Centre for Colorectal Disease, St Vincent's University Hospital and School of Medicine, University College Dublin, Gastroenterology, Dublin, Ireland.

PMID: 34160593
DOI: 10.1093/ecco-jcc/jjab112

ECCO Topical Review: Refractory Inflammatory Bowel Disease

Tim Raine et al. J Crohns Colitis. 2021.

. 2021 Oct 7;15(10):1605-1620.

doi: 10.1093/ecco-jcc/jjab112.

Authors

Affiliations

¹ Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
² Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
³ Department of Chronic Diseases and Metabolism, TARGID - IBD, KU Leuven, Leuven, Belgium.
⁴ Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
⁵ Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
⁶ Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece.
⁷ Department of Gastroenterology, Monash Health and School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.
⁸ Department of Medicine 1, University of Erlangen-Nürnberg, Erlangen, Germany.
⁹ Gastrounit, Medical Division, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
¹⁰ Colorectal and General Surgery, Beaumont Hospital, Dublin, Ireland.
¹¹ Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta.
¹² Karolinska Institutet, Department of Medicine Solna, Stockholm, Sweden.
¹³ Karolinska University Hospital, Gastroenterology Unit, Department of Gastroenterology, Dermatovenereology and Rheumatology, Stockholm, Sweden.
¹⁴ Department of Colon & Rectal Surgery, Cleveland Clinic, Cleveland, OH, USA.
¹⁵ Department of Gastroenterology and Hepatology, University and Medical School of Ioannina, Ioannina, Greece.
¹⁶ Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium.
¹⁷ Medical Faculty of the Friedrich Schiller University, Jena, Germany.
¹⁸ Centre for Colorectal Disease, St Vincent's University Hospital and School of Medicine, University College Dublin, Gastroenterology, Dublin, Ireland.

PMID: 34160593
DOI: 10.1093/ecco-jcc/jjab112

Erratum in

Correction.
[No authors listed] [No authors listed] J Crohns Colitis. 2023 Jan 27;17(1):149. doi: 10.1093/ecco-jcc/jjac104. J Crohns Colitis. 2023. PMID: 35971821 Free PMC article. No abstract available.

Abstract

Inflammatory bowel disease is a chronic disease with variable degrees of extent, severity, and activity. A proportion of patients will have disease that is refractory to licensed therapies, resulting in significant impairment in quality of life. The treatment of these patients involves a systematic approach by the entire multidisciplinary team, with particular consideration given to medical options including unlicensed therapies, surgical interventions, and dietetic and psychological support. The purpose of this review is to guide clinicians through this process and provide an accurate summary of the available evidence for different strategies.

Keywords: Crohn’s disease; Inflammatory bowel disease; refractory; ulcerative colitis; unlicensed medication.

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Comment in

Letter to the Editor.
ECCO Governing Board. ECCO Governing Board. J Crohns Colitis. 2022 Nov 23;16(11):1792-1793. doi: 10.1093/ecco-jcc/jjab225. J Crohns Colitis. 2022. PMID: 35073577 No abstract available.

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ECCO Topical Review: Refractory Inflammatory Bowel Disease

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ECCO Topical Review: Refractory Inflammatory Bowel Disease

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