Cure8 news brief
The study suggests starting anti-TNF therapy with an immunomodulator at diagnosis may reduce surgery, hospital stays, and progression to complicated Crohn’s over 5 years — outcomes that matter to patients and clinicians when choosing initial treatment strategy.
Adults newly diagnosed with Crohn’s disease, clinicians who treat IBD, and patients considering biologic or combination therapy.
This report summarizes 5-year follow-up data from the PROFILE trial, a multicentre randomized study of 386 adults newly diagnosed with Crohn’s disease in the UK. Patients were randomized to a top-down strategy (infliximab plus an immunomodulator) versus conventional step-up care. Median follow-up after the 48-week visit was ~5 years.
The primary outcome presented was Crohn’s disease–related abdominal surgery: 6 surgeries occurred in the top-down group versus 28 in the step-up group. The step-up group also had higher rates of hospital admission and greater progression to stricturing or penetrating disease.
The authors report adjusted hazard ratios favoring early top-down therapy across these outcomes. If you are considering treatment approaches, discuss with your gastroenterologist whether early biologic therapy is appropriate for your disease features; this article reports trial results but is not a treatment recommendation.
These findings are from the 5-year follow-up of the PROFILE randomized trial reported in Lancet Gastroenterology & Hepatology. Trial participants were treated in UK centres and nearly all patients in both arms received biologic or immunomodulator therapy at some point, which may influence generalizability. Discuss applicability to individual cases with a clinician.
Review the original publication for the complete reporting, methods, and context.
This Cure8 brief is based on source text from the linked article. Cure8 is informational only and is not a substitute for professional medical advice, diagnosis, or treatment.
Early “top-down” infliximab plus an immunomodulator was linked to much lower 5-year risk of abdominal surgery, disease progression, and hospitalization versus a step-up approach. This could influence treatment planning...
The 5-year PROFILE follow-up is presented as strong evidence that early, effective therapy (in this case infliximab plus an immunomodulator) can change the long-term course of Crohn’s disease by lowering surgery rates...
The findings give clinicians and patients data on how often biologic therapy leads to endoscopic remission in biologic‑naïve patients with isolated small‑bowel Crohn's disease, and they suggest similar effectiveness...
