- Early treatment with infliximab plus an immunomodulator (top-down therapy) showed more frequent steroid-free and surgery-free remission at 1 year compared to conventional therapy in patients with newly diagnosed Crohn’s disease.
- Research Findings: The research reported a significant difference in sustained remission with top-down therapy versus accelerated step-up treatment. The top-down approach was also found to be safer, with fewer adverse events.
- Study Details: The study, known as the PROFILE trial, was an open-label, randomized controlled trial. It involved 379 adults newly diagnosed with active Crohn’s disease. The primary endpoint was sustained steroid-free and surgery-free remission to week 48.
- Treatment Efficacy: In the top-down group, 79% of patients achieved sustained remission compared to only 15% in the accelerated step-up group. This resulted in an absolute difference of 64 percentage points.
- Safety and Adverse Events: The top-down group experienced fewer adverse events and serious adverse events, including complications requiring abdominal surgery and serious infections, compared to the step-up group.
Case appears clearcut’: Top-down therapy should be ‘standard of care’ for new Crohn’s (Healio)
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