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Initiation of Immunomodulators (thiopurines and methotrexate)

This IBD clinical care pathway provides a guideline for health care providers when initiating immunomodulators (thiopurines and methotrexate) and its use in adults with inflammatory bowel disease.

Use the Pathway

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Clare McCabe Woodrow (Alberta Health Services) and Dr. Natasha Bollegala (Women’s College Hospital & University of Toronto) are the leads for this clinical care pathway, including regular review and maintenance.

Last reviewed and updated in January 2026.

Disclaimer
Clinical care pathways are not a substitute for the personalized judgement and care of a trained healthcare professional. 

Additional resources

For IBD providers

 

 

  • Canada has among the highest incidence rates of Crohn's and colitis in the world.
  • 1 in 140 Canadians lives with Crohn’s or colitis.
  • Families new to Canada are developing these diseases for the first time.
  • Incidence of Crohn’s in Canadian kids under 10 has doubled since 1995.
  • People are most commonly diagnosed before age 30.

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