“Top-down” approach or classic step therapy?

The standard treatment of Crohn’s disease (Crohn’s disease) is based on the “step-up” strategy. However, results from the PROFILE study indicate that in newly diagnosed Crohn’s disease, early use of a TNF-α inhibitor in combination with an immunomodulator is significantly more effective than stepwise escalation. The recently published results of several years of follow-up show that this also applies to the longer-term outcomes. As interesting as these study results are, in terms of a “best practice” approach, the guideline advises that the respective course of treatment should be assessed individually using surrogate parameters and adjusted accordingly depending on the response.