hospitalization required Maintenance of Remission: Immunomodulators (azathioprine, 6-MP, methotrexate) for steroid-dependent or frequently-relapsing disease Biologic monotherapy or combination therapy (biologic + immunomodulator) for moderate-to-severe disease Step-up or top-down approach based on disease severity, patient risk factors, and prior therapy Biologic Therapy Targets: TNF-: Infliximab (IV), adalimumab (SC), certolizumab pegol (SC) IL-12/23: Ustekinumab (IV induction, SC maintenance) Integrin: Vedolizumab (IV) IL-23: Risankizumab (IV induction, SC maintenance) JAK inhibition: Upadacitinib (oral) Surgical Management Surgery is indicated in approximately 7080% of patients with Crohns disease over their lifetime, per StatPearls
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Educational commentary
Both forms ultimately provide vitamin B activity, but hydroxocobalamins longer duration in the body means injections can be given less frequently in maintenance therapy
A red rash that begins a few days after the pain Fatigue Fever and chills Fluid-filled blisters that break open and crust over Headache Sensitivity to light Sensitivity to touch Stomach upset How to Diagnose and Treat Shingles Typically, dermatologists begin the diagnosis of this condition with a detailed evaluation of the pain symptoms including the history of pain on one side of your body, along with the rash and blisters