Crohn's disease watchful waiting approach for newly diagnose
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In newly diagnosed Crohn's disease patient waiting approach can be beneficial without the development of further complications.

An early treat-to-target approach in Crohn’s disease (CD) patients are recommended to avoid complications. However, CD may not always progress despite lack of treatment, thus exposing some patients to unnecessary side effects. A study was published by the International Journal of Colorectal Disease on whether newly diagnosed CD patients with an inflammatory phenotype can benefit from a watchful waiting approach.

This retrospective cohort study followed CD patients with an inflammatory phenotype who were diagnosed between 2010 and 2015 and followed for at least 1 year. A watchful waiting approach was defined as maintenance therapy with 5-ASA medication only or no treatment during the first year of diagnosis or longer. Disease complications were defined as a need for surgery or change in the disease phenotype.

Eighty-six patients were included and followed-up. Thirty-seven patients were managed with a watchful waiting approach and 49 with early therapeutic intervention. The majority of patients (83.8%) in the watchful waiting group did not develop disease complications. In this group, there was no difference in clinical disease severity between those who did not develop complications and those who did. Smoking was associated with a complicated course.

Conclusively a watchful waiting approach of newly diagnosed CD patients with an inflammatory phenotype may be a feasible option, with low long-term complication rates specifically in nonsmoking patients.

Source: https://doi.org/10.1007/s00384-020-03811-8
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