title: Combination therapy for the treatment of Crohn's disease.
abstract: BACKGROUND
  Crohn's disease (CD) is an idiopathic inflammatory disorder of the gastrointestinal tract traditionally treated by the step-wise use of corticosteroids, antimetabolites and TNF-α antagonists. However, recent evidence indicates that the early introduction of drug combinations might be a superior strategy to step-care.
  
  
  METHODS
  In this article, we review existing literature regarding the efficacy and safety of combination drug therapy for the management of CD. Five major databases: MEDLINE, EMBASE, PubMed, the Cochrane Library (CENTRAL) and DDW abstracts were electronically searched from inception to February 2015 for any relevant studies.
  
  
  CONCLUSIONS
  Existing data strongly support the use of combination therapy for CD. The benefit of this approach appears to outweigh any associated risks. Until the role of gut selective therapies are better established, combination therapy should be considered the standard treatment approach for CD.
authors.affiliation: a 1 University of Western Ontario, Robarts Research Institute, Robarts Clinical Trials, Department of Medicine , 100 Perth Dr., London, ON N6A 5K8, Canada Brian.feagan@robartsinc.com.|b 2 King Abdulaziz University, King Abdulaziz University Hospital, Department of Medicine , Jeddah , Saudi Arabia.|c 3 Department of Medicine, King Abdulaziz University , Jeddah , Saudi Arabia.
authors.forename: Mahmoud H
authors.initials: MH
authors.lastname: Mosli
authors.affiliation: a 1 University of Western Ontario, Robarts Research Institute, Robarts Clinical Trials, Department of Medicine , 100 Perth Dr., London, ON N6A 5K8, Canada Brian.feagan@robartsinc.com.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Feagan
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D019804:Mesalamine / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000378:metabolism
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005765:Gastrointestinal Agents; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D019804:Mesalamine; D000069285:Infliximab
keywords: Crohn’s disease; TNF antagonists; combination therapy; immunosuppressives; monoclonal antibody; therapy