In which patient groups is a top-down therapy indicated for the management of Crohn disease?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

At present, it is clear that a subset of patients with Crohn disease is at a higher risk for complications of the disease; these individuals should be considered for top-down therapy. Poor prognostic indicators include young age at diagnosis, perianal disease, upper GI tract involvement, multiple extraintestinal manifestations (EIMs), active tobacco use, and perforating (ie, fistulizing) disease.


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