The traditional approach to therapy of Crohn’s disease has been the step-up approach usually represented as a pyramid (Fig. 7.1) where, progressing from mild to severe disease, therapeutic choices proceed step by step from less potent drugs at the basement of the pyramid to more potent but also more toxic drugs at the top. The advent of biological therapies and the wider use of immunomodulators, together with the opportunity to achieve ambitious treatment goals and possibly to modify the course of disease, have led to other approaches such as the accelerated step-up or the top-down approach. This means that immunomodulators and biologics can be used earlier and de-escalated when disease is in deep remission. This could allow prolonged remission.
Standard Therapeutic Approach and New Therapies
Viola A.
2015-01-01
Abstract
The traditional approach to therapy of Crohn’s disease has been the step-up approach usually represented as a pyramid (Fig. 7.1) where, progressing from mild to severe disease, therapeutic choices proceed step by step from less potent drugs at the basement of the pyramid to more potent but also more toxic drugs at the top. The advent of biological therapies and the wider use of immunomodulators, together with the opportunity to achieve ambitious treatment goals and possibly to modify the course of disease, have led to other approaches such as the accelerated step-up or the top-down approach. This means that immunomodulators and biologics can be used earlier and de-escalated when disease is in deep remission. This could allow prolonged remission.Pubblicazioni consigliate
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