Top down or step up? IBD treatment approach still not clear-cut

Top-down treatment versus a step-up strategy does not appear to result in increased clinical remission during long-term follow-up of patients with Crohn’s disease, a long term follow up study has shown. The findings contrast with the demonstrated short-term benefit of top-down treatment i.e. early combined immunosuppression in the pivotal 2008 Step-up/Top-down-trial. However the treatment landscape ...

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