Thursday, March 06, 2008
Earlier use of these agents in Crohn's disease not only may be associated with superior clinical outcomes, but also may have the potential to alter the natural history of the disease. Physicians should begin to recognize that a subgroup of Crohn's disease patients should be considered for a "top-down" approach. The goal should be to identify high-risk patients in whom the introduction of early and more aggressive with biologics can be justified. In time, however, it is likely that larger randomized controlled trials will conclude that the "top-down" treatment is superior to the traditional "step-up" treatment algorithmn.
