| [ Summary ] |
Which of these options is better for Crohn's disease (CD) patients, a combination therapy with an immunomodulator or a monotherapy with anti-TNF-α ? The issue has long been debated upon, since the introduction of infliximab in the treatment of inflammatory bowel disease (IBD). However, the issue has not been fully resolved yet, due to lack of scientific evidence, except the results of the SONIC trial. Designing and conducting clinical trials with the goal to determine effectiveness or ineffectiveness of such a combination therapy is generally difficult, because of difficulty in setting a definite endpoint. Therefore, physicians should use treatment tailored to each patient's disease condition, according to stage and preference, based on the available, but limited evidence. In addition, physicians should interpret new emerging studies regarding these issues, extra cautiously. Most of those studies would describe only biased results using a biased cohort with a skewed study design. |