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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
Doshis note: Glutathione can support skin brightening in selected patients, but it should never be seen as an instant or permanent fairness treatment
Enhanced cellular polysulfides negatively regulate TLR4 signaling and mitigate lethal endotoxin shock