Kerur B, et al. - The recent risk of bowel surgery was investigated in an inception cohort of pediatric patients with Crohn's disease (CD). Researchers also examined if early use of biologics (tumor necrosis factor antagonists) alters later disease course. Data analysis from a registry of pediatric patients with CD revealed that early surgery is difficult to prevent among those with significant and progressing disease at or shortly after presentation, even with early use of biologics. They observed that early use of biologics (within 3 months of diagnosis) could delay later disease progression to stricturing and/or penetrating disease. However, this affect could become evident only years after initial management decisions are made.