Implications of COVID-19 for inflammatory bowel disease: Opportunities and challenges amidst the pandemic

Table 1 Management of inflammatory bowel disease medications during the Coronavirus disease 2019 pandemic

Medications	Clinical case scenarios
	Stable IBD without SARS-CoV-2 infection	Quiescent IBD with positive SARS-CoV-2 infection	Active IBD with positive COVID-19 infection (irrespective of severity)
Sulfasalazine and 5-aminosalicylates	Continue therapy	Continue therapy	Continue therapy
Budesonide	Continue therapy	Unclear evidence	Unclear evidence
Oral/Parenteral steroids	Discontinue/Delay therapy	Discontinue/Delay therapy	Discontinue/Delay therapy
Immunomodulators (methotrexate and thiopurines)	Continue therapy	Discontinue/Delay therapy	Discontinue/Delay therapy
Anti-tumor necrosis factor inhibitors (infliximab, adalimumab, certolizumab and golimumab)	Continue therapy	Unclear evidence	Discontinue/Delay therapy
Anti-integrins (vedolizumab)	Continue therapy	Unclear evidence	Unclear evidence
Anti-interleukins (ustekinumab	Continue therapy	Unclear evidence	Discontinue/Delay therapy
Janus kinase inhibitors (tofacitinib)	Continue therapy	Discontinue/Delay therapy	Discontinue/Delay therapy

IBD: Inflammatory bowel disease; COVID-19: Coronavirus disease 2019; SARS-CoV-2: Severe acute respiratory syndrome coronavirus-2.