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I read with interest the study by Steenholdt et al1 which concluded that individualised infliximab therapy was more cost effective compared with empirical dose escalation in Crohn's disease (CD) patients who developed secondary non-response to infliximab.
The study methodology has a number of questions that require attention.
First, 80% of the patients recruited for the study had non-fistulising disease, and the study entry criterion for them was having a Crohn's Disease Activity Index (CDAI) score of ≥220. Furthermore, the endpoint for clinical response …