In the last decades, with the development of biological therapy, the treatment paradigms in patients with Crohn's disease have continuously evolved. Several studies focusing on the optimal use of both traditional immunosuppressants and biological therapy have been published, investigating conventional, accelerated step-up and top-down approaches. In addition, much emphasis has been placed in recent years on the determination of important predictive factors that could enable early patient stratification, which would lead to a tailored management strategy. In this review, the authors try to highlight new evidence on the optimal timing, benefits, and risks of immunosuppressants alone, or in combination, in patients with Crohn's disease.
Keywords: Azathioprine; Biologicals; Crohn’s disease; Immunosuppressives; Thiopurine methyltransferase.