| [ Summary ] |
Presently in Japan, there are two different biologicsagents, infliximab (IFX) and adalimumab (ADA), for the treatment of Crohn's disease. Both of these agents inhibit TNF-alpha and have been shown to achieve not only clinical but endoscopic remission. To maximize the power of those biologics a "top-down" strategy has been proposed for IFX, as may be the case with ADA. However, there are no definite plans to do so yet. Maintenance with biologic therapy is no doubt necessary. In cases where there is a loss of response to therapy, IFX dose intensification or concomitant use of immune-modulators may be a treatment option. In such cases it is very important to consider whether the patients require surgical intervention. |