Plain Language Summary The PROFILE study, published in 2024, compared two ways of treating people newly diagnosed with moderate to severe Crohn's disease. One approach starts highly effective anti‐TNF treatment immediately after diagnosis (‘top‐down’), whereas the other increases treatment step by step only if the disease worsens (‘step‐up’). The study showed that starting effective treatment early leads to better disease control and improved safety. This review focuses on the recently published economic analysis of the PROFILE study. Over a five‐year modelled period, the ‘top‐down’ approach was associated with lower overall healthcare costs, mainly because patients experienced fewer disease flare‐ups, required fewer hospital admissions and underwent fewer intestinal surgeries. Similar cost advantages were observed when lower cost anti‐TNF alternative, adalimumab, was taken into consideration. The reliability of these findings was supported by their consistency across multiple sensitivity analyses. Early anti‐TNF treatment may be particularly important for patients with more aggressive forms of Crohn's disease, as it may help prevent the development of complications. Ongoing follow‐up of the PROFILE study will provide further information on long‐term clinical outcomes and the broader economic impact of this treatment strategy, which in an era of widely available and increasingly affordable biosimilars, will be particularly relevant for healthcare systems and treatment guidelines.
Michal Prokopič (Fri,) studied this question.