ARTICLE IN PRESSJID:YDLDm5G:February13,2023:14:10]Digestive and Liver Disease xxx (xxxx)xxxContents lists available at Science DirectDiseaseDigestive and Liver DiseaseELSEVIERjournal homepage:www.elsevier.com/locate/dldGuidelinesUse of biologics for the management of Crohn's disease:IG-IBDclinical guidelines based on the GRADE methodologyFabio Salvatore Macaluso,Claudio Papib,Ambrogio Orlando2,Stefano Festab,Daniela Pugliese,Stefanos Bonovas de,Claudia Pansierid.e,Daniele Piovanid.e,Gionata Fiorino,Massimo Claudio Fantini,Flavio Caprioli,Marco DapernoAlessandro Armuzzid.*,Italian Group for the Study of Inflammatory Bowel Disease(IG-IBD),Working panel,Review panelIBD Unit,'Villa Sofia-Cervello"Hospital Palermo,ItalyIBD Unit."San Filippo Neri"Hospital,Rome,ItalyCEMAD,IBD Unit,Dipartimento di Scienze Mediche e Chirrgiche,Fondazione Policlinico Universitario "A.Gemelh"IRCCS,Rome,ItalyDepartment of Biomedical Sciences,Humanitas University.Pieve Emanele,Milan,Italye RCCS Humanitas Research Hospital,Rozzano,Milan,ItalyGastroenterology and Digestive Endoscopy,San Camillo-Forlanini Hospital,Rome,ItalyGastroenterology and Digestive Endoscopy,Vita-Salute San Raffaele University,Milan,ItalyDepartment of Medical Science and Public Health,University of Cagliari University Hospital of Cagliari Unit of Gastroenterology,Caglari,ItalyDepartment of Pathophysiology and Transplantation,Universiti degli Studi di Milano,Milan,ItalyGastroenterology and Endosopy Unit.Fondazione IRCCSCa Granda,Ospedale Maggiore Policlinico di Mikno,Mikn.ItalyGastroenterology Unit,"Mauriziano"Hospital,Turin,ItalyIBD Center,IRCCS Humanitas Research Hospital,Rozzano,Milan,ItalyARTICLEABSTRACTArticle history:A cure for Crohn's disease (CD).a chronic inflammatory disease of the gastrointestinal tract of unknownReceived 6 September 2022etiology.is not available,so patients require lifelong management to keep inflammation under control.Accepted 18 January 2023The therapeutic armamentarium has expanded with approval of several biological drugs,including in-Available online xxxfliximab,adalimumab,vedolizumab and ustekinumab-monoclonal antibodies that target different in-Keyword本flammatory pathways-and darvadstrocel,a suspension of expanded human allogeneic,adipose-derivedBiologicsmesenchymal stromal cells for the treatment of refractory complex perianal fistula.Notwithstanding ex-Clinical guidelinesisting practice guidelines on medical therapy for CD,the Italian Group for the Study of InflammatoryCrohn's diseaseBowel Disease felt the need to issue new guidelines focused on the use of biologics for managing theGRADEintestinal manifestations of CD and based on the GRADE methodology.This document presents recom-G-IBDmendations regarding six clinical settings,from the induction to the maintenance of clinical remission,and from optimization and de-escalation of treatments to dealing with perianal CD and post-operativerecurrence.The 19 evidence-based statements are supported by information on the qualit
