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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

Individual responses vary, but some individuals may experience improvements in energy levels and symptoms within a few days after starting B12 injections.

Diab Ther

Any Vitamin B12 that is not required by the body is excreted in the urine

Peptic ulcer disease represents a logical target indication, with animal models demonstrating accelerated ulcer healing and reduced ulcer formation with both systemic and local BPC-157 administration