title: Catching the therapeutic window of opportunity in early Crohn's disease.
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.
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
authors.forename: Gionata
authors.initials: G
authors.lastname: Fiorino
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernandes
authors.affiliation: IBD Center, Department of Gastroenterology, Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy. sdanese@hotmail.com.
authors.forename: Laureal
authors.initials: L
authors.lastname: Peyrin-Biroulet
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D003424:Crohn Disease / Q000175:diagnosis* / Q000188:drug therapy*; D057210:Delayed Diagnosis; D042241:Early Diagnosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D011379:Prognosis; D012074:Remission Induction
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents