infliximab + azathioprine (Sapienza University of Rome)

Top-down-University of Roma La Sapienza-Crohn's disease refers to a specific therapeutic regimen and clinical trial protocol evaluated by the University of Roma La Sapienza for the treatment of pediatric Crohn's disease. This top-down approach involves the early initiation of combination therapy with infliximab and azathioprine at the time of diagnosis, rather than following the traditional step-up model of starting with corticosteroids. Infliximab is a chimeric monoclonal antibody that binds to and neutralizes tumor necrosis factor-alpha (TNF-α), a central mediator of inflammation in Crohn's disease. Azathioprine is an immunosuppressive small molecule that acts as a purine analogue, interfering with DNA synthesis and inhibiting the proliferation of inflammatory T-cells. The regimen aims to achieve rapid clinical remission and mucosal healing to prevent long-term complications and growth impairment in pediatric patients with moderate-to-severe disease.

Brand names

RemicadeImuran

Other names

Top-down-University of Roma La Sapienza-Crohn's diseaseTop-down therapyInfliximab Top-Down vs Step-Up in Pediatric Crohn's Disease trial