Emerging issues in the medical management of Crohn's disease.

PURPOSE OF REVIEW: This article describes why this review is timely and relevant. The medical management of Crohn's disease is complex, and is changing rapidly with the introduction of novel therapeutic agents and management strategies.

RECENT FINDINGS: We have summarized and synthesized up-to-date evidence and opinion on the proper role and composition of combined immunosuppressive therapy in the management of Crohn's disease, the optimal time for introduction of immunomodulator and/or biologic therapies, and the benefits of therapeutic drug monitoring for biologic therapies. We also discuss the evidence supporting the benefits of the novel agents vedolizumab and ustekinumab, and discuss where they will fit into the therapeutic landscape.

SUMMARY: The review will provide evidence to support decision making in patients with Crohn's disease requiring biologic and/or immunomodulator therapy.