Redefining Early Intervention and the Window of Opportunity in Crohn's Disease

Crohn's disease is a chronic, progressive inflammatory bowel condition characterized by unpredictable episodes of flare and remission. Inflammation that is not controlled, and even in instances when inflammation is controlled, often has a substantial impact on quality of life for individuals with Crohn's disease, affecting relationships, education, and work productivity. The concept of a therapeutic window of opportunity has long been recognized as a period within which to maximize effectiveness of interventions and potentially modify the course of disease. However, there has been considerable uncertainty over the years on when the window of opportunity is, or how early should early effective intervention be in Crohn's disease. In recent years, there has been a growing body of evidence supporting early intervention to maximize benefit and improve outcomes for patients, and several seminal studies have provided insights into the true window of opportunity. This article summarizes the latest evidence for early effective intervention and considers when to intervene in the therapeutic window of opportunity to maximize outcomes and quality of life for people living with Crohn's disease.