Review: Tailoring the treatment to the individual in Crohn's disease

Crohn's disease is a heterogeneous disease with approximately 30-40% of patients having a simple benign history and the rest having a chronic progressive disease leading to complications, surgeries and potentially socio-professional marginalisation. Recent studies have shown that an early treatment with immunosuppressive treatment and/or anti-tumour necrosis factor agents could change the natural history of the disease and avoid the development of such disabling disease. The therapy should thus be tailored according to the risk of developing such disabling disease. Recent cohort studies have shown that clinical factors such as age at diagnosis, disease extent, disease location and behaviour at diagnosis were predictive for the development of severe or disabling disease and could be used in helping the physician to tailor therapy.