New Steroid-free Treatment for Crohn’s Disease

A recent study published in The Lancet suggests a better way to treat Crohn’s disease. The research was conducted by Dr. Brian Feagan, Director of Robarts Clinical Trials at the University of Western Ontario. The new treatment method has the added benefit of avoiding the use of steroids in an otherwise slow and not entirely effective approach, known as the ‘step-up’ approach.


The ‘step-up’ approach was not living up to its name as many patients were not recovering and were suffering the poor effects of steroid use even after the treatment was over. Steroid treatment has been linked with metabolic disease and even death. Step up also incorporated immune-suppressing drugs and an antibody to curb inflammation in the patient.
A new strategy is now being introduced called “top-down”. It uses immune-suppressing drugs and antibodies, just like the “step-up” approach, but steroids are not included in the regimen. Initial results have been very promising.

The two-year study involved 129 subjects suffering from Crohn’s disease. 64 participants received the conventional “step up” treatment, while the remaining 65 were managed with “top-down” approach. 36% of the patients who had received the step-up approach were symptom-free after the 26th week of the new study, in comparison to 60% of the “top-down” patients.
The positive results for patients of Crohn’s disease do not end there. Patients with Rheumatoid Arthritis and other chronic auto-immune diseases, such as Ulcerative Colitis, may also benefit from this new form of therapy.

Source: University of Western Ontario