While there isn’t a cure for Crohn’s disease yet, newer medications may improve quality of life and time spent in remission. Researchers are focusing on potential ways to prevent and cure Crohn’s.
Researchers are looking for new ways to treat Crohn’s disease symptoms, as well as possible cures. Newer treatments are using medications that block inflammation at the source rather than after the inflammation has occurred.
Researchers are also trying to uncover treatments that are more specific to the intestinal tract.
Here, we take a look at drugs in the pipeline that may be effective at helping treat symptoms or even prevent or cure Crohn’s.
Also, we review the existing available treatments.
Though treatments exist, there’s currently no cure for Crohn’s disease. Treatment goals typically involve reducing symptoms due to inflammation and limiting any complications.
If the treatment works, it can lead to:
- symptom relief
- reduced symptoms and complications
- managed inflammation
In 2020, a research group found a microscopic marker that could help identify people who are likely to have an inflammation recurrence. Ongoing research efforts could allow individualized therapeutic intervention at an earlier stage.
This type of symptom prediction has the potential to improve long-term symptom relief for people with Crohn’s.
RHB-104 is one of the promising new drugs in the pipeline.
Studies are ongoing to uncover the exact role of the MAP bacterium in Crohn’s disease, as not all researchers agree. It seems that only some people with Crohn’s disease have a MAP infection, and some people with a MAP infection do not have Crohn’s disease.
The bacterium causes serious intestinal infections in cattle, similar to Crohn’s disease in humans. As a result of this knowledge, several studies are underway to see if antibiotics that treat MAP may help people with Crohn’s disease.
The first clinical trial of RHB-104, an antibiotic cocktail of clarithromycin, rifabutin, and clofazimine, was completed in the summer of 2018 and reported results. The authors suggest a statistically significant link between RHB-104 and clinical remission.
More studies are still needed. It’s not clear whether anti-MAP therapies help people achieve remission or how the treatment compares to other Crohn’s medications.
A year-long study conducted between 2018 and 2019 in the United Kingdom was designed to study the safety of an anti-MAP vaccine for humans. A total of 28 volunteers were recruited from Oxford, England.
The protocol involves two different vaccines and various doses of each. Only after safety is established can researchers do a randomized trial on effectiveness.
If it is deemed effective, it could be 5 to 10 years before it becomes available.
A phase I study has shown promise for an oral, ATP-competitive, JAK1 selective inhibitor called AZD4205. It was tested on animal subjects and healthy human volunteers, and it was well tolerated with no drug-related negative effects so far.
A phase II study involving participants with moderate to severe Crohn’s disease is in the works.
Currently, there’s no known cure for Crohn’s disease. Treatment for the condition traditionally focuses on reducing symptoms. It’s also sometimes effective at bringing a person’s Crohn’s disease into long-term remission.
Crohn’s is generally treated with medications. The first-line approach to reducing Crohn’s symptoms is to reduce inflammation in the bowel. In some cases, doctors may recommend surgery for complications that cannot be treated another way.
Doctors typically recommend one or more of the following treatments:
- anti-inflammatory drugs
- immune system suppressors to help reduce bowel inflammation
- antibiotics to help heal ulcers and fistulas and to help reduce the number of harmful bacteria in the intestines
- fiber supplements
- pain relievers
- iron, calcium, and vitamin D supplements
- vitamin B12 injections to help reduce risks of malnutrition
- nutritional therapy, such as a special diet plan or liquid diet to help reduce risk of malnutrition
- surgery to remove damaged parts of the digestive system for symptom relief
Corticosteroids, such as prednisone, have long been beneficial for people with Crohn’s disease. However, they’re limited to short-term use when other treatments aren’t effective. This is because they can have many serious side effects on the entire body.
More recently developed corticosteroids, such as budesonide and beclomethasone dipropionate,
More research is still needed to determine if budesonide and beclomethasone are actually more effective at reducing symptoms.
Immune system suppressors
Common immune system suppressors that doctors traditionally use to treat Crohn’s disease include azathioprine (Imuran) and mercaptopurine (Purinethol). But research has found that they can cause side effects, including an increased risk of infection.
Another drug in this category is methotrexate, Typically, it’s used in addition to other medications. All immune system suppressor drugs require regular blood tests to monitor potential side effects.
Newer drugs, called biologics, are used to treat Crohn’s disease in people with moderate to severe cases. Not everyone may be a candidate for these medications as their use can depend on an individual’s overall health.
TNF inhibitors work by blocking a protein that causes inflammation.
Some examples include:
- infliximab (Remicade)
- adalimumab (Humira)
- certolizumab pegol (Cimzia)
Two additional TNF inhibitors are adalimumab-atto (Amjevita) and adalimumab-adbm (Cyltezo), which are both FDA-approved biosimilar drugs to Humira.
It’s important to note that researchers have also found that for some people, TNF inhibitors may become less effective over time.
Natalizumab (Tysabri) and vedolizumab (Entyvio)
These drugs are also used to treat moderate to severe Crohn’s disease in people who don’t respond well to other medications. They block inflammation in a different way than TNF inhibitors. Rather than blocking TNF, they block a substance called integrin.
They work by keeping inflammatory cells out of tissue. However, Natalizumab (Tysabri) carries a risk of developing a serious brain condition called progressive multifocal leukoencephalopathy (PML) in certain people. Doctors typically order tests for the JC virus before prescribing this medication to reduce this risk.
Vedolizumab works similarly to natalizumab, but so far it
Ustekinumab (Stelara) is the most recent biologic approved to treat Crohn’s. It’s used in the same way as other biologics. A
This drug works by blocking certain pathways of inflammation. However, in rare instances, it can also affect the brain.
Since reducing inflammation is often the goal for Crohn’s symptom relief, research has targeted mesenchymal stem cells (MSCs) as a strong anti-inflammatory tool.
A 2020 study on bone-marrow-derived mesenchymal stromal cell therapy showed long-term improvement in perianal Crohn’s disease fistulas.
More studies are needed to determine the effect of stem cells on symptoms of Crohn’s disease.
A recent study of a microbiome-targeting diet called the IBD-Anti-Inflammatory Diet (IBD-AID) showed that 61.3% of participants following the diet for at least 8 weeks reported a dramatic decrease in the severity of symptoms.
The diet focuses on probiotic and prebiotic foods and avoiding:
- trans fats
- processed foods
- foods that contain lactose, wheat, refined sugar, and corn
The following includes commonly asked questions about Crohn’s disease research and the progress toward a cure.
Can Crohn’s disease ever go away?
While there’s currently no cure for Crohn’s disease, medication can help decrease the severity and frequency of symptoms, and may help achieve remission.
How long does a person with Crohn’s live?
The life expectancy for people with Crohn’s disease has improved in recent years. A
How serious is Crohn’s disease?
While Crohn’s disease is not life threatening, it can lead to potentially serious complications. Treatment and dietary changes may help reduce symptoms and complications.
Can you live a normal life with Crohn’s disease?
Crohn’s disease can be effectively managed with treatment, including medication and other therapies, to help reduce the frequency and severity of symptoms while increasing the time spent in remission.
It’s important to note that some therapies may affect the immune system and increase the risk of infection.
As the understanding of Crohn’s disease continues to improve, there’s an encouraging expectation that more effective treatment options may be available in the future.
Having a Crohn’s specialist on your medical team is one way to help ensure you’re receiving accurate information about your disease, as well as keeping up to date on any new treatment options.