Strategies in Crohn’s disease treatment – „step-up” vs. „top-down”

Abstract

Inflammatory bowel diseases (IBD) are chronic conditions that lead to serious complications and act to the detriment of quality of patients’ lives. Etiology of IBD has not been precisely determined but it is assumed that IBD is caused by genetic, immune and environmental factors. The main target in current IBD treatment is the induction and maintenance of remission. The most common strategy in IBD therapy is called „step-up” that is based on gradual introduction of stronger drugs. However, the latest research shows that „top down” strategy is more prom-ising and can change the natural course of the disease. The aim of this article is to discuss both strategies and compare their effectiveness.