Intest Res.  2019 Jul;17(3):285-310. 10.5217/ir.2019.00026.

Best practices on immunomodulators and biologic agents for ulcerative colitis and Crohn's disease in Asia

  • 1Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
  • 2Duke-NUS Medical School, Singapore.
  • 3Department of Medicine, Faculty of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
  • 4Asian Institute of Gastroenterology, New Delhi, India.
  • 5Gleneagles Medical Centre, Singapore.
  • 6Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
  • 7Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • 8Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
  • 9Gastroenterology and Hepatology, Bumrungrad International University, Bangkok, Thailand.
  • 10Division of Gastroenterology, The First University Hospital, Sun Yat-sen University, Guangzhou, China.
  • 11Department of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
  • 12Department of Gastroenterology and IBD Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 13Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 14Division of Gastroenterology and Hepatology, National University Hospital of Singapore, University Medicine Cluster, Singapore.
  • 15University of Malaya Specialist Centre, Kuala Lumpur, Malaysia.
  • 16Department of Medicine, University of Santo Tomas, Manila, Philippines.
  • 17Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, Singapore.
  • 18Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Hong Kong.
  • 19Faculty of Medicine, UKM Medical and Specialist Centres, The National University of Malaysia, Kuala Lumpur, Malaysia.
  • 20Department of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • 21Department of Internal Medicine, School of Medical Sciences, Health Campus, Sains University, Kubang Kerian, Malaysia.
  • 22Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
  • 23The Third Department of Internal Medicine, Kyorin University School of Medicine, Mitaka, Japan.
  • 24Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea.
  • 25Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.
  • 26Department of Medicine, University of Otago, Christchurch, New Zealand.
  • 27Faculty of Medicine, University of Kelaniya, Dalugama, Sri Lanka.
  • 28Department of Medicine, Chulalongkorn University, Bangkok, Thailand.
  • 29Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
  • 30Division of Gastroenterology, Department of Internal Medicine, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
  • 31Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia.


The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.


Inflammatory bowel disease; Crohn disease; Colitis, ulcerative; Infliximab; Adalimumab

MeSH Terms

Asian Continental Ancestry Group
Biological Factors*
Biosimilar Pharmaceuticals
Colitis, Ulcerative*
Cooperative Behavior
Crohn Disease*
Hepatitis B
Immunologic Factors*
Inflammatory Bowel Diseases
Practice Guidelines as Topic*
Biological Factors
Biosimilar Pharmaceuticals
Immunologic Factors
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