Combined Immunosuppression for Pediatric Crohn's Disease

This trial is testing whether adding a biologic drug (either anti-TNF therapy or ustekinumab) alongside an immune-modulating drug at the start of treatment produces better results than standard step-up therapy for children with moderate-to-severe Crohn's disease. **You may be eligible if...** - Your child is between 6 and 18 years old with a diagnosis of Crohn's disease - Their Crohn's disease is moderately to severely active (PCDAI score above 30 or endoscopy score above 10) - Their disease did not adequately improve after initial treatment with nutritional therapy or steroids - They have not previously received biologic drugs targeting TNF **You may NOT be eligible if...** - Your child has previously received a biologic anti-TNF drug - Your child has had Crohn's disease-related surgery - Your child has active infections or a tumor Talk to your doctor to see if this trial is right for you.