Inflammatory Bowel Disease Clinical Care Pathways

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

Download the PDF

This Clinical Care Pathway was updated from the previous December 2024 version.

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

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.

Additional resources

For IBD providers

• Harvey Bradshaw Index 
• Partial Mayo Scoring Index
• Therapy decision tree for Crohn’s disease
• Therapy decision tree for ulcerative colitis

For people with IBD

• Azathioprine or 6-Mercaptopurine (6-MP) for IBD
• Taking Azathioprine