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NICE publishes Crohn's management guidance

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The National Institute for Clinical Excellence (NICE) has issued new guidance on how best to manage Crohn’s disease.

Over the past 10 years, there have been a series of new medications for treating the chronic inflammatory condition. These include glucocorticosteroids to get rid of symptoms as well as azathioprine and mercaptopurine to help prevent flare-ups of the condition.

NICE has now issued guidance which looks at the role of these drugs in caring for patients with Crohn’s disease.

It advises that patients who are suffering from the symptoms of Crohn’s disease for either the first time or for the first time in a year should be given a glucocorticosteroid such as prednisolone, methylprednisolone or intravenous hydrocortisone.

Anyone who has used either azathioprine or mercaptopurine along with either a conventional glucocorticosteroid or budesonide to stop Chrohn’s disease symptoms should be offered the drug by itself to prevent them returning.

And healthcare professionals should talk to patients about their lifestyle when they are in remission to identify the risks of symptoms returning and anything they can do to help prevent that.

Discussions about drugs they can take should include making sure they are aware of any side effects, NICE said. All the opinions of the patient about the management of their condition should be entered on their medical records.

NICE also recommends that in patients where the disease only affects the distal ileum, carrying out surgery could be an option for early treatment of the condition instead of prescribing drugs.

But all the risks should be weighed against the benefits and the patient’s personal opinion taken into consideration.

The guidance also highlights the importance of offering a full range of support tailored to suit the age of the patient to help them cope with any worries they have about living with Crohn’s disease, including helping young people to manage the condition while at school, college or university.


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