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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: A \u201ctop-down\u201d infliximab\/immunomodulator therapy reduced long-term risk for abdominal surgery vs. a \u201cstep-up\u201d approach in newly diagnosed Crohn\u2019s. It also lowered risk for disease progression and hospitalization. CHICAGO \u2014 Early treatment with infliximab and an immunomodulator was associated with more than five times reduced risk for abdominal surgery at 5 years among patients with newly diagnosed Crohn\u2019s disease, according to a presenter. Follow-up PROFILE trial data presented at Digestive Disease Week showed that early control of inflammation during a 48-week treatment period also lowered long-term risk for disease progression and hospitalization.
Nurulamin \u201cNuru\u201d Noor, MD, speaks at Digestive Disease Week.\u00a0Image: Robert Stott.
\u201cHistorically, there has been a reluctance among some clinicians to use a \u2018top-down\u2019 approach due to potential concerns about overtreatment,\u201d Nurulamin \u201cNuru\u201d Noor, MD, clinical lecturer in gastroenterology at University of Cambridge, said at the presentation. \u201cOver 5 years follow-up, we found no difference in safety outcomes between the two groups, either for serious infections or malignancies. \u201cPatients receiving \u2018top-down\u2019 infliximab from diagnosis had a more than five times lower risk of Crohn\u2019s disease-related abdominal surgery.\u201d Prior data from the randomized, controlled PROFILE trial showed improved clinical outcomes at 48 weeks for patients who received the \u201ctop-down\u201d therapy approach with infliximab and an immunomodulator compared with an accelerated \u201cstep-up\u201d strategy, or conventional treatment. Noor and colleagues followed 386 participants for a median 5 years after the 48-week visit to evaluate whether early treatment can impact long-term outcomes of Crohn\u2019s disease. They reviewed medical records for abdominal surgeries, hospital admissions and disease progression. Follow-up data were available for 358 patients (93%), of whom 182 received top-down therapy and 176 received step-up therapy. Analysis showed 28 Crohn\u2019s-related abdominal surgeries were required among patients who received step-up therapy compared with six surgeries among those who received top-down therapy (adjusted HR = 5.23: 95% CI, 1.99-13.76). Time to surgery also was earlier in the step-up group. Patients who received top-down therapy were about 2.5 times less likely to experience disease progression and two times less likely to be hospitalized. \u201cOur data suggest that the course of Crohn\u2019s disease can be modified with therapy and this should be considered the standard of care,\u201d Noor said. Published by: Sources\/Disclosures Source: Noor N, et al. Profile trial 5-year disease modification outcomes. Presented at: Digestive Disease Week; May 2-5, 2026; Chicago.
Disclosures:
Noor reports educational or travel grants and\/or speaker fees from AbbVie, Bristol Myers Squibb, Celltrion, Falk, Ferring, Johnson & Johnson, Eli Lilly and Co., Medfyle, Pfizer, Pharmacosmos, Spyre, Takeda and Tillotts Pharma. Please see the study for all other authors\u2019 relevant financial disclosures.
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