I think the strength of any treatment is a matter of relativity. The way I see it my own treatment requires self-discipline, mental and physical perseverence and I can hose down flares - literally, starting with a homemade saline water enema followed by lglutamine/lactoferrin boost - that would earlier floor me in a matter of days.
The tier is based on levels of aggressiveness, a different ball game, so biologics is considered a more 'aggressive approach' compared to mesalamine due to potentially more hazardous side effects given it is an immunsupressor. So strength comes from success. In that LDN qualifies as an equally strong treatment for the original poster.
Post Edited (isleman) : 7/14/2016 9:27:41 AM (GMT-6)