Early use of anti-TNF agents might give a helping hand to paediatric patients with Crohn's disease

摘要

Initial decisions concerning the early treatment of paediatric patients with Crohn's disease are of crucial importance, both to promote the best possible quality of life in these patients and to limit any potential drug-related effects on their subsequent growth development. "If we knew who was likely to do poorly and who was likely to do well at diagnosis, it would certainly help to direct our therapies," states Jeffrey Hyams, corresponding author of a new study investigating this issue, now published in Gastroenterology.Immunomodulators (most commonly thiopurines) are the traditional early treatment for patients with moderate-to-severe Crohn's disease. However, whether these agents alter the natural history of the disease or affect children's growth potential remains unclear. The development of anti-TNF agents was an important advance in the medical management of paediatric Crohn's disease, yet the optimal position of these agents in therapeutic algorithms for paediatric patients is still poorly defined.