Practical application of anti-TNF therapy for luminal Crohn's diseasea


  • Conflicts of interest: Michael Kamm has served as a consultant and speaker to Abbott, Schering-Plough, and UCB. Stephen Hanauer has received grants for clinical research and educational activities from, and has served as an advisor or consultant to, Shire, P&G Pharmaceuticals, Salix, Abbott, Centocor, UCB, and Prometheus.

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    Author contributions: M.A. Kamm (study concept and design; study supervision, critical revision of article), S.C. Ng (Literature search, drafting of article, revision of article), P. D'Cruz (literature search, drafting of article), PAllen (Literature search, drafting of article), S Hanauer (critical revision of article).


Anti-tumor necrosis factor (TNF) therapy to treat inflammatory bowel disease has been available for more than a decade. Although extensive data on the outcome of anti-TNF therapy from individual clinical trials and patient cohorts are available, integrated guidance on the best use of such therapy to achieve optimal clinical outcomes when managing patients with luminal Crohn's disease is lacking. This review combines published data to establish practical strategies for anti-TNF therapy with respect to effective and safe timing of introduction, use of concurrent immunosuppressive therapy, dose escalation, managing relapse, changing drugs, pregnancy and breast feeding, and stopping drug treatment. (Inflamm Bowel Dis 2011;)