NICE versus ECCO/ESPGHAN guideline
| NICE | ECCO/ESPGHAN | |
|---|---|---|
| Induction acute severe | ||
| 1st line | Intravenous corticosteroids | Intravenous corticosteroids |
| 2nd line | Intravenous ciclosporin or colectomy | Intravenous calcineurin inhibitor or infliximab or colectomy |
| 3rd line | Colectomy | Colectomy |
| Induction mild-moderate | ||
| 1st line | Oral and/or topical aminosalicylates, ± oral beclometasone in addition to topical aminosalicylates | Oral and/or topical aminosalicylates |
| 2nd line | Oral prednisolone | Oral prednisolone |
| 3rd line | Oral tacrolimus | Intravenous corticosteroids then consider tacrolimus or infliximab |
| Maintenance | ||
| 1st line | Oral and/or topical aminosalicylates (combination preferred; topical sufficient for proctitis) in mild-moderate disease | |
| 2nd line | Thiopurines (following single acute severe exacerbation, or >2 flares/year, or chronic activity despite aminosalicylates) | |
| 3rd line | Colectomy | Infliximab or colectomy |
ECCO, European Crohn's and Colitis Organisation; ESPGHAN, European Society for Paediatric Gastroenterology, Hepatology and Nutrition; NICE, National Institute for Health and Care Excellence.