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The textbooks describe a stepwise approach from mesalamine or sulfasalazine, through systemic prednisone with or without an immunomodulator (such as azathioprine, methotrexate or 6-mercaptopurine), to TNF-alpha inhibitor biologics, injectable medicines that block a key inflammation signal (infliximab, adalimumab, golimumab or certolizumab pegol), the IL-12/IL-23 inhibitor ustekinumab, or the anti-adhesion antibody vedolizumab for refractory disease

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