Figure 3.
Consensus guidance for the treatment of idiopathic multicentric CD. Adapted from van Rhee et al.84 iMCD patients should be stratified for disease severity per Table 4. *For patients with mild symptomatology, a limited course of rituximab is an alternative option. †Accelerated weekly dosing of anti-IL-6 therapy is recommended for the first month along with daily assessment of the patient's status. If organ dysfunction worsens at any time, initiation of combination chemotherapy should be considered (see text). ‡Examples of therapies are listed in Table 5. Green is category 1 evidence: based on high-level evidence; there is uniform consensus that the intervention is appropriate. Gold is category 2A evidence: based on lower-level evidence; there is uniform consensus that the intervention is appropriate. Blue is category 2B evidence: based on lower-level evidence; there is consensus that the intervention is appropriate. CR, complete response; HD steroids, high-dose steroids; mAb, monoclonal antibody; PR, partial response.