TNF and Crohn disease: A landmark pragmatic randomized controlled trial (RCT) conducted in Belgian and Canadian non-academic centres showed that early introduction of combined immunosuppression with an anti-TNF agent and an anti-metabolite immunomodulator in persons with Crohn’s disease reduced the risk of surgery, hospital admission, and/or serious disease-related complications at 24 months as compared to conventional step-up therapy (27.7% and 35.1%, absolute difference: 7.3%, hazard ratio: 0.73; 95% CI: 0.62 to 0.86; p < 0.001) (15).