Title:Catching the Therapeutic Window of Opportunity in Early Crohn`s Disease
Volume: 15
Issue: 11
Author(s): Silvio Danese, Gionata Fiorino, Carlos Fernandes and Laureal Peyrin-Biroulet
Affiliation:
Keywords:
Crohn’s disease, early disease, inflammatory bowel disease, therapy.
Abstract: Crohn’s disease (CD) is a chronic, disabling, progressive and destructive disease. The general goal of conventional
step-up strategy in CD treatment is to treat and control symptoms. This strategy did not change the disease course
and is now being replaced with a treat-to-target approach. Achieving deep remission (clinical remission and absence of
mucosal ulcerations) is the target in CD in 2014. Inducing and maintaining deep remission is needed to prevent long-term
outcomes such as bowel damage and disability in CD. Diagnostic delay is a common issue in CD and is associated with an
increased risk of bowel damage over time. Identification of poor prognostic factors, risk stratification together with the
development of “red flags” may result in early intervention with disease-modifying agents such as anti-TNF agents with
the final aim of preventing overtreatment and avoiding undertreatment. Similar to rheumatoid arthritis, by catching the
therapeutic window of opportunity in early CD and achieving deep remission, this could be the best way to change disease
course (hospitalizations, surgeries, bowel damage, and disability) and patients’ life.
