For a diagnosed acute flare of severe Crohn disease, which therapy is recommended?

In cases of an acute flare of severe Crohn's disease, Prednisone is the recommended therapy due to its effectiveness as a corticosteroid in rapidly reducing inflammation. Corticosteroids are well-established for managing acute exacerbations of inflammatory bowel disease due to their potent anti-inflammatory properties.

Prednisone works by suppressing the immune response, leading to a decrease in inflammation and symptoms associated with flares. It is particularly beneficial in the short term for severe cases, where prompt control of inflammation is necessary to improve patient condition and alleviate symptoms.

Other medications like Azathioprine and Mesalamine are more suited for long-term maintenance therapy rather than for managing acute severe exacerbations. Azathioprine is an immunosuppressant that is typically used for maintenance therapy to prevent flares rather than treat them acutely. Mesalamine, an aminosalicylate, is primarily used for mild to moderate cases of ulcerative colitis and Crohn's disease and is ineffective during severe flare-ups, as it does not impact the acute phase rapidly or sufficiently.

Budesonide may be used for mild to moderate Crohn's disease but is not preferred for severe acute flares since it has a milder effect compared to systemic corticosteroids like Prednisone