Evidence continues to grow that patients with Crohn's disease should be aggressively treated with advanced therapy as early as possible after diagnosis, rather than first turning to less-powerful corticosteroids.
Still, many clinicians aren't yet with the program. An analysis of 2019-2023 insurance data found that nearly half of newly diagnosed patients with Crohn's started out by taking corticosteroids (step-up therapy) instead of biologics and immunomodulators (top-down therapy).
There's a significant risk to the step-up strategy, Marla Dubinsky, MD, of Mount Sinai Kravis Children's Hospital in New York City, told MedPage Today. "Every day that we delay using advanced therapies in the patients that most need it is a day that we are not taking advantage of changing the trajectory of the disease," she said.
Here's a look at what we know about first-line therapy in Crohn's.
Evidence Supports Top-Down Strategy
