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The goals of treating inflammatory bowel disease (IBD) have evolved from merely controlling symptoms to blocking disease progression and improving long-term disease outcomes.

In this prospective cohort study, recently published in , Laharie et al. found that achieving a single time point of clinical and endoscopic remission in biologic-naive patients with early Crohn's disease, who received infliximab [Remicade] in combination with an immunosuppressant, was not associated with improved long-term disease outcomes.

Interestingly, patients who achieved the desired endpoint (corticosteroid-free clinical remission from weeks 22 through 54) had similar rates of surgery, hospitalization, and the need for new systemic treatments as patients who did not reach the recommended endpoint. However, the data did show a low rate of surgery in the entire cohort, pointing to the importance of the early use of combination therapy with a tumor necrosis factor inhibitor and conventional immunosuppressants.

A limit of this work is that the study was based on an existing trial and was not powered for long-term comparisons; thus, the study should be interpreted with caution.

Overall, the study supports the use of early aggressive treatments for Crohn's disease and suggests that a flexible treat-to-target concept could be taken in daily practice.

Melinda Engevik, PhD, is an assistant professor at Medical University of South Carolina in Charleston.

You can read an interview with the lead study author here, and the abstract of the study here.