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'Top-down' therapy linked to fivefold lower risk for abdominal surgery in Crohn's disease
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 for people newly diagnosed with Crohn’s disease.
Newly diagnosed Crohn’s patients, patients considering early biologic therapy, clinicians who treat IBD, and researchers studying disease-modification strategies.
What To Know
Key finding: Follow-up data from the randomized PROFILE trial presented at Digestive Disease Week reported that a “top-down” strategy (infliximab plus an immunomodulator early after diagnosis) was associated with a more than fivefold lower risk of Crohn’s-related abdominal surgery at 5 years compared with a step-up approach.
The study also reported lower risk of disease progression and hospitalization with top-down therapy and no difference in serious infections or malignancies between groups.
What this means: This report suggests early biologic plus immunomodulator therapy may change longer-term outcomes for newly diagnosed Crohn’s disease patients, including fewer surgeries and hospitalizations over 5 years.
However, the article summarizes a conference presentation of trial follow-up data rather than providing full published peer-reviewed results in the text. Practical note: Decisions about starting early combination therapy depend on many factors (disease severity, patient preferences, safety concerns, and clinician judgment).
If you are newly diagnosed or caring for someone who is, discuss risks and benefits of early biologic-based strategies with your gastroenterology team. Source details: The coverage summarizes a PROFILE trial 5-year follow-up presented at Digestive Disease Week; the presenter and disclosures are listed in the article.
The article summarizes conference presentation data from the PROFILE trial; full peer-reviewed publication and detailed safety/long-term analyses may provide more context. Treatment choices should be individualized and discussed with clinicians.
