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Updated: Apr 14, 2026

Evaluating Therapeutic Interventions in the SHIP-deficient Mouse Model of Crohn Disease-like Ileitis and Fibrosis
Published on: October 14, 2025
Which patients with inflammatory bowel disease should receive combination therapy?
1Department of Medicine, Division of Gastroenterology and Hepatology, University of Maryland, 100 North Greene Street, LL Baltimore, MD 21201, USA.
Abstract:
Traditionally, patients with inflammatory bowel disease underwent 'step-up' therapy to induce a clinical remission. However, when step-up treatment is used, the more efficacious anti-TNF agents are reserved for patients unable to achieve remission with immune suppressants (IS). Several pivotal trials have demonstrated the superiority of early combination therapy of IS and anti-TNF to 'step-up' therapy and azathioprine or infliximab monotherapy. Concerns about treatment cost and adverse events of combination therapy have precluded widespread adoption of early combination therapy. Recent studies have demonstrated that combination treatment followed by withdrawal of IS or infliximab was not associated with an increased rate of relapse. Providers must include the benefits and risks of combination therapy in shared decision-making discussions with patients about to start treatment. Improved diagnostic and prognostic tests in the future are likely to help providers select the ideal patient for combination therapy.
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