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Journal of Crohn's and Colitis: 9 (11)


Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium


Published on behalf of

On the updated ECCO consensus guidelines for medical management of Crohn's disease

Dirk Esser, Freddy Cornillie, Robert H. Diamond, Robert J. Spiegel
DOI: http://dx.doi.org/10.1016/j.crohns.2010.02.002 165-166 First published online: 1 April 2011

Dear Sir,

During the 2009 annual meeting of the European Crohn's and Colitis Organisation (ECCO), the updated consensus guidelines for medical management of Crohn's disease (CD) were presented. ECCO deserves recognition for using a rigorous, evidence-based approach in developing these guidelines. However, whilst we acknowledge our own interests as marketing authorisation holder and distributor of Remicade, we would like to respectfully point out our objections to an assumption of a class effect between anti-TNF agents, as the updated guidelines and in particular section 5I suggest:

All currently available anti-TNF therapies appear to have similar efficacy and adverse-event profiles, so the choice depends on availability, route of delivery, patient preference, cost and national guidance [EL5, RG D].

Firstly, the different biologics targeting TNF-α have different molecular structures and seem to have different clinical effects. For example, the anti-TNF drug etanercept, although currently indicated for use in other inflammatory diseases, was not efficacious in CD clinical trials, and is not indicated for treatment of CD.1 Likewise, development of the monoclonal anti-TNF antibody CDP571 in CD was stopped …

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