When is a step-down approach used in the treatment of inflammatory bowel disease (IBD)?

Updated: Apr 10, 2020
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Answer

Drugs from different therapeutic classes may be used additively. In patients with moderate to severe or high-risk disease, a step-down approach with early introduction of stronger agents such as the anti-TNF agents has been advocated to prevent complications and improve patient outcomes. There are many situations, especially in patients with more severe disease, where early use of anti-TNF agents or other biologics is clearly in the patient’s best interest.


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