简介：CorticosteroidsandimmunomodulatorshavebeenthemainstaytherapiesforCrohn’sdisease.Corticosteroidsarehighlyeffectivetocontrolsymptomsintheshort-term,buttheyarenoteffectiveinmaintainingremission,theyhealthemucosainareducedproportionofcases,andlong-timeexposureisassociatedwithanincreasedriskofinfectionsandmortality.Immunomodulators,azathioprineandmethotrexate,healthemucosainahigherproportionofpatientsthatcorticosteroidsbuttheironsetofactionisslowandtheybenefitlessthanhalfofpatientswithCrohn’sdisease.Inthelastdecade,medicaltherapyforCrohn’sdiseasehasexperiencedaremarkablechangeduetotheintroductionofbiologictherapy,andparticularlytheuseofanti-tumournecrosisfactor-alphaagents.Infliximab,adalimumab,andcertolizumabpegolhavedemonstratedefficacyforinductionandmaintenanceofremissioninactiveCrohn’sdisease.TheseagentshaveraisedthebarforwhatisasuitablesymptomaticresponseinCrohn’sdiseaseandmodificationofthenaturalhistoryofthediseasehasbecomeamajorgoalinthetreatmentofCrohn’sdisease.Thereareseveraldataintheliteraturethatsuggestthatearlyuseofbiologictherapyandachievementofmucosalhealingcontributetodiseasecoursemodification.However,manyquestionsonearlybiologicaltherapyforCrohn’sdiseaseremainstillunanswered.

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