| [ Summary ] |
For Crohn's disease, it is important to induce remission before the formation of an irreversible lesion on the small intestine. Step‒up (SU) therapy is now the standard strategy for Crohn's disease, which starts from steroid administration, and immunosuppressants and anti‒TNF‒α antibody should be administered for poor responders. Recently, the availability of top‒down (TD) therapy has been reported, which starts administration of anti‒TNF‒α antibody and immunosuppressants. However, the long‒term prognosis with SU or TD therapy, and the indication of SU or TD therapy for mild cases are not clear. The choice of treatment strategy is regarded as a future important issue. |