TY - JOUR
T1 - Early intervention in Crohn's disease
T2 - Towards disease modification trials
AU - Danese, Silvio
AU - Fiorino, Gionata
AU - Peyrin-Biroulet, Laurent
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Crohn's disease (CD) is a chronic progressive destructive inflammatory bowel disease. As in rheumatoid arthritis, there is increasing evidence that early treatment initiation with disease-modifying agents, such as biological drugs, may lead to complete disease control, prevention of disease progression thus protecting against irreversible damage and restoration of normal quality of life. Data from randomised clinical trials with immunosuppressants and biologics suggest that treating patients with a disease duration of <2 years and an absence of complications may significantly reduce the risk for complications and increase time in remission in patients with CD. Moreover, rapid disease control may effectively prevent disease progression and allow dose reduction or even withdrawal of treatment, reducing the risk of long-term adverse events and healthcare costs. However, prospective disease modification trials are needed to confirm these initial results. Here we review the literature regarding early intervention in adult patients with CD and propose criteria for future disease modification trials.
AB - Crohn's disease (CD) is a chronic progressive destructive inflammatory bowel disease. As in rheumatoid arthritis, there is increasing evidence that early treatment initiation with disease-modifying agents, such as biological drugs, may lead to complete disease control, prevention of disease progression thus protecting against irreversible damage and restoration of normal quality of life. Data from randomised clinical trials with immunosuppressants and biologics suggest that treating patients with a disease duration of <2 years and an absence of complications may significantly reduce the risk for complications and increase time in remission in patients with CD. Moreover, rapid disease control may effectively prevent disease progression and allow dose reduction or even withdrawal of treatment, reducing the risk of long-term adverse events and healthcare costs. However, prospective disease modification trials are needed to confirm these initial results. Here we review the literature regarding early intervention in adult patients with CD and propose criteria for future disease modification trials.
KW - Crohn's disease
KW - immunoregulation
KW - pharmacotherapy
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U2 - 10.1136/gutjnl-2017-314519
DO - 10.1136/gutjnl-2017-314519
M3 - Article
C2 - 28874419
AN - SCOPUS:85037652112
VL - 66
SP - 2179
EP - 2187
JO - Gut
JF - Gut
SN - 0017-5749
IS - 12
ER -