Biological Therapies in Inflammatory Bowel Disease: Top-down or Bottom-up?

Bas Oldenburg; Daan Hommes

Curr Opin Gastroenterol. 2007;23(4):395-399.

Conclusion

The great advances in medical therapy in IBD have encouraged researchers and physicians to define new and ambitious goals in the treatment of this chronic intermittent disease. The top-down approach is appealing and may result in a modification of the natural history in a subgroup of IBD patients. To date, however, data on the benefits, risks and costs of a reversal of the traditional therapeutic pyramid are limited. In the future, long-term studies aimed at the comparison of the traditional sequential approach and top-down strategies, preferably in homogeneous groups of IBD patients, should guide the clinician in deciding in whom, when and how to introduce early aggressive treatment in daily practice.

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Abbreviation Notes

IBD = inflammatory bowel disease; NF = tumour necrosis factor; RA = rheumatoid arthritis.

Reprint Address

Bas Oldenburg, Department of Gastroenterology, University Medical Center Utrecht, Roomnumber F02.618, Heidelberglaan 100, 3574 CD Utrecht, The Netherlands Tel: +31 30 250 9111; fax: +31 30 250 5533; e-mail: b.oldenburg@umcutrecht.nl

Cite this: Biological Therapies in Inflammatory Bowel Disease: Top-down or Bottom-up? - Medscape - Jul 01, 2007.

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