Role of Biomarkers for the Management of Crohn’s Disease

Publication Date: November 15, 2023
Last Updated: August 8, 2024

Patients with CD in symptomatic remission

Recommendation 1

In patients with CD in symptomatic remission, the AGA suggests a monitoring strategy that combines biomarkers and symptoms, rather than relying on symptoms alone.

( Low , Conditional (weak) )

Comment: Patients who place a higher value on avoiding the burden of biomarker testing, over a potentially higher risk of flare and disease progression caused by missing subclinical inflammation, may reasonably choose interval symptom-based monitoring.

Implementation considerations:
Interval biomarker monitoring may be performed every 6–12 mo in patients in symptomatic remission.
Biomarker-based monitoring may be particularly useful in patients w biomarkers have historically correlated with endoscopic disease activity

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Patients with symptomatically active CD

Recommendation 5

In patients with symptomatically active CD, the AGA suggests a biomarker-based assessment and treatment adjustment strategy, rather than relying on symptoms alone. ( Moderate , Conditional (weak) )
Comment: Patients who place a higher value on avoiding the burden of biomarker testing, over a potentially higher risk of over- or undertreatment if relying only on symptoms, may consider choosing interval symptom-based treatment adjustment when being treated for active symptoms.

Implementation considerations:
  • Interval biomarker assessment and treatment adjustment may be performed every 2–4 mo in patients being treated for active symptoms.
  • After resolution of symptoms (and normalization of biomarkers), endoscopic (and/or radiologic) evaluation should be performed to rule out active inflammation, typically 6–12 mo after treatment initiation or adjustment. The patient may then transition to guidance for patients in symptomatic remission.
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Overview

Title

Role of Biomarkers for the Management of Crohn’s Disease

Authoring Organization

American Gastroenterological Association