Anti-TNF Antibodies for Crohn's Disease — In Pursuit of the Perfect Clinical Trial

For decades, many patients with Crohn's disease required prolonged courses of corticosteroids, repeated surgeries, or both, despite treatment with 5-aminosalicylic acid (mesalamine) or immunomodulators such as azathioprine. The introduction of infliximab, the first antibody against tumor necrosis factor α (TNF-α), dramatically changed the treatment of patients with Crohn's disease.1 Administered as an intermittent parenteral therapy, infliximab proved efficacious in patients whose condition was resistant to treatment, and the drug is widely used for such patients. However, the infliximab experience served to reinforce the adage that there often is much to be learned about new medications. We soon discovered that patients . . .