Crohn's Disease

Efficacy of Advanced Therapies in Achieving Remission by Disease Location in Crohn's Disease: A Systematic Review and Meta-analysis.

Lee HH, Yuan Y, Boland BS, Chang JT, Jairath V, Singh S · Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026 · n=3139

We compared the efficacy of different advanced therapies by disease location in patients with Crohn's disease (CD) through a systematic review and meta-analysis. Through a systematic review, we identified 14 randomized controlled trials in 3139 patients with moderate-to-severe CD who were treated with different advanced therapies vs placebo, and reported efficacy in inducing clinical remission, stratified by disease location (isolated colonic vs ileal disease, excluding ileocolonic disease). We grouped advanced therapies based on the primary mechanism of action: anti-interleukins, Janus kinase inhibitors (JAK inhibitors), anti-integrins, and tumor necrosis factor (TNF) antagonists. We calculated treatment efficacy (drug vs placebo), overall and by drug class, for colonic vs ileal disease. Overall treatment efficacy of advanced therapies vs placebo was higher in patients with colonic (odds ratio [OR], 4.09; 95% confidence interval [CI], 3.02-5.54) vs ileal CD (OR, 1.80; 95% CI, 1.23-2

Network Meta-Analysis: Comparative Efficacy of Biologics and Small Molecules in the Induction and Maintenance of Remission in Crohn's Disease.

Shehab M, Alrashed F, Alrashidi A, Hassan A, Ma C, Narula N · Alimentary pharmacology & therapeutics · 2025

Advances in medical management of Crohn's disease (CD) have transformed therapeutic goals. Clinical and endoscopic remission are important endpoints. To compare the efficacy of different advanced therapies in patients with CD. We performed a literature search up to January 2025. We included phase 3 randomised controlled trials (RCTs) against placebo or an active comparator. The primary endpoint was induction and maintenance of clinical remission (CD Activity Index [CDAI] < 150 points). Secondary endpoints included induction and maintenance of endoscopic remission (Simple Endoscopic Score for CD (SES-CD) of ≤ 4 or CD Endoscopic Index of Severity (CDEIS) of ≤ 4). We performed network meta-analysis (NMA) using the Frequentist method. We included 39 studies. Induction of clinical remission analysis showed that infliximab combination with azathioprine ranked highest (93.2%), followed by guselkumab (88.6%) and adalimumab (76.9%). Guselkumab was superi

Associations of 2923 plasma proteins with incident inflammatory bowel disease in a prospective cohort study and genetic analysis.

Zhang X, Zhao H, Wan M, Man J, Zhang T, Yang X · Nature communications · 2025

The prospective relationship between proteomics and inflammatory bowel disease (IBD) remains largely underexplored, presenting potential of therapeutic interventions. Using data from 48,800 IBD-free participants in the UK Biobank Pharma Proteomics Project (UKB-PPP), we assessed associations between 2923 plasma proteins and incident IBD risk using Cox analysis. Mendelian randomization (MR) meta-analysis, integrating cis-protein quantitative trait loci data from the UKB-PPP with IBD genome-wide association study data from the International Inflammatory Bowel Disease Genetics Consortium and FinnGen studies, identified causal proteins. Colocalization analysis strengthened evidence of shared common causal variants. Cohort study revealed associations of 673, 295, and 125 proteins with the risk of IBD, Crohn's disease (CD), and ulcerative colitis (UC), respectively. MR and colocalization analyses prioritized IL12B, CD6, MXRA8, CXCL9, IFNG, CCN3, RSPO3, and IL18 as having causal and high coloc

Diet, Food, and Nutritional Exposures and Inflammatory Bowel Disease or Progression of Disease: an Umbrella Review.

Christensen C, Knudsen A, Arnesen EK, Hatlebakk JG, Sletten IS, Fadnes LT · Advances in nutrition (Bethesda, Md.) · 2024

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), contributes to substantial morbidity. Understanding the intricate interplay between dietary factors and the incidence and progression of IBD is essential for developing effective preventative and therapeutic strategies. This umbrella review comprehensively synthesizes evidence from systematic reviews and meta-analyses to evaluate these complex associations. Dietary factors associated with an increased incidence and/or progression of IBD include a high intake of red and processed meat, other processed foods, and refined sugars, together with a low intake of vegetables, fruits, and fiber. For most other food groups, the results are mixed or indicate no clear associations with IBD, CD, and UC. Some differences seem to exist between UC and CD and their risk factors, with increased intake of dietary fiber being inversely associated with CD incidence but not clearly associated with UC. Dietary fiber

Systematic review of sarcopenia in inflammatory bowel disease.

Fatani H, Olaru A, Stevenson R, Alharazi W, Jafer A, Atherton P · Clinical nutrition (Edinburgh, Scotland) · 2023

There is growing evidence of increased muscle atrophy in IBD patients, likely resulting in a higher sarcopenia prevalence in IBD. The aims of this systematic review are A1; to estimate sarcopenia prevalence in IBD patients, A2; to investigate its impact on IBD patients, and A3; the effectiveness of nutritional interventions on muscle mass and/or strength in IBD patients. On 28 July 2021, three electronic databases were used to identify eligible studies, including peer-reviewed studies (randomised controlled trials [RCTs], non-RCTs, observation studies) in adult (⩾ 18 years) IBD patients. For A1 and A2 only, studies defined low muscle mass and/or strength cut-off points. For A2, studies assessed association between sarcopenia and IBD complication. For A3, studies assessed the nutrition effect among IBD patients. 35 studies were included, 34 for A1, 20 for A2, and three for A3. 42% of adult IBD patients have myopenia, 34% have pre-sarcopenia, and 17% sarcopenia. Myopenic IBD was

Cannabis for the treatment of Crohn's disease.

Kafil TS, Nguyen TM, MacDonald JK, Chande N · The Cochrane database of systematic reviews · 2018 · n=21

Crohn's disease (CD) is a chronic immune-mediated condition of transmural inflammation in the gastrointestinal tract, associated with significant morbidity and decreased quality of life. The endocannabinoid system provides a potential therapeutic target for cannabis and cannabinoids and animal models have shown benefit in decreasing inflammation. However, there is also evidence to suggest transient adverse events such as weakness, dizziness and diarrhea, and an increased risk of surgery in people with CD who use cannabis. The objectives were to assess the efficacy and safety of cannabis and cannabinoids for induction and maintenance of remission in people with CD. We searched MEDLINE, Embase, AMED, PsychINFO, the Cochrane IBD Group Specialized Register, CENTRAL, ClinicalTrials.Gov, and the European Clinical Trials Register up to 17 October 2018. We searched conference abstracts, references and we also contacted researchers in this field for upcoming publications. Randomized controll

ACG Clinical Guideline: Management of Crohn's Disease in Adults.

Lichtenstein GR, Loftus EV, Afzali A, Long MD, Barnes EL, Isaacs KL · The American journal of gastroenterology · 2025

Crohn's disease (CD) is an idiopathic inflammatory disorder of unknown etiology with genetic, immunologic, and environmental influences. The incidence of CD has steadily increased over the past several decades. The diagnosis and treatment of patients with CD has evolved since the last practice guideline was published. These guidelines represent the official practice recommendations of the American College of Gastroenterology and were developed under the auspices of the Practice Parameters Committee for the management of adult patients with CD. These guidelines are established for clinical practice with the intent of suggesting preferable approaches to medical problems as established by interpretation and collation of scientifically valid research, derived from extensive review of published literature. When exercising clinical judgment, health care providers should incorporate this guideline along with patient's needs, desires, and their values to care for patients fully and appropriate

ACG Clinical Guideline Update: Preventive Care in Inflammatory Bowel Disease.

Farraye FA, Melmed GY, Lichtenstein GR, Barnes EL, Limketkai BN, Caldera F · The American journal of gastroenterology · 2025

Patients with inflammatory bowel disease (IBD) often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to patients with IBD, health maintenance issues need to be addressed by the gastroenterology team. In particular, documentation and recommendation for vaccinations are crucial because more than 70% of patients with IBD will at some time be on immune-modifying therapies that may increase the risk for infections, many of which are preventable with vaccinations. Health maintenance recommendations addressed in this guideline include the safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer and screening for depression, anxiety, and need for smoking cessation. To accomplish these health maintenance goals, coordination among the primary care provider, gastroenterology team, and other specialists is necessary.

British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025.

Moran GW, Gordon M, Sinopolou V, Radford SJ, Darie AM, Vuyyuru SK · Gut · 2025

In response to recent advancements in inflammatory bowel disease (IBD) management, the British Society of Gastroenterology (BSG) Clinical Services and Standards Committee (CSSC) has commissioned the BSG IBD section to update its guidelines, last revised in 2019. These updated guidelines aim to complement the IBD standards and promote the use of the national primary care diagnostic pathway for lower gastrointestinal symptoms to enhance diagnostic accuracy and timeliness. Formulated through a systematic and transparent process, this document reflects a consensus of best practices based on current evidence. The guideline, while developed primarily for the UK, is structured to support IBD management internationally. It is endorsed by the BSG executive board and CSSC without external commercial funding, with involvement primarily supported through professional roles in public institutions and the National Health Service (NHS). Methodological revisions since the prior guidelines have enhance

Whole Food Diet Induces Remission in Children and Young Adults With Mild to Moderate Crohn's Disease and Is More Tolerable Than Exclusive Enteral Nutrition: A Randomized Controlled Trial.

Aharoni-Frutkoff Y, Plotkin L, Pollak D, Livovsky J, Focht G, Lev-Tzion R · Gastroenterology · 2025 · n=41

Tasty&Healthy (T&H) is a whole food diet for Crohn's disease (CD) that excludes processed food, gluten, red meat, and dairy, without requiring formula or mandatory ingredients. TASTI-MM was a clinician-blinded, randomized controlled trial comparing tolerability and effectiveness of T&H vs exclusive enteral nutrition (EEN). Patients with biologic-naïve mild to moderate CD and aged 6-25 years were randomized to either T&H or EEN for 8 weeks, receiving weekly dietary support. Tolerability was evaluated by weekly interviews, questionnaires, and intake diaries. Other outcomes included symptomatic remission, Mucosal-Inflammation Noninvasive index, calprotectin, C-reactive protein, and erythrocyte sedimentation rate. Fecal microbiome was analyzed by metagenomics at baseline, week 4, and week 8. Data were analyzed by the intention-to-treat approach unless specified otherwise. Among 83 included patients (n = 41 T&H, n = 42 EEN; mean ± SD age, 14.5 ± 3.7 year

Nutritional Management in Stricturing Crohn's Disease: A Pilot Study.

Cavalcanti E, Marra A, Mileti A, Donghia R, Curlo M, Mastronardi M · Nutrients · 2024

More than half of patients with Crohn's disease develop intestinal fibrosis induced intestinal obstruction with debilitating symptoms throughout their disease course. The incidence of stricture formation in CD has remained unchanged over the last several decades. Factors promoting intestinal fibrosis are currently unclear, but diet may represent an underestimated risk factor for intestinal fibrosis by modification of both the host immune response and intestinal microbial composition. Evaluating the impact of diet on the course of IBD is very complex. Sarcopenia is a common problem in IBD patients and correlates with an increased rate of disease. Skeletal muscle index (SMI) is an important parameter to measure sarcopenia and is an easily accessible tool for evaluating the likelihood of complications in individuals with CD. Using a randomized and controlled pilot design, we aimed to investigate the efficacy of 12 months of short-term dietary intervention based on essential amino acid (E

Physical Training and Healthy Diet Improved Bowel Symptoms, Quality of Life, and Fatigue in Children With Inflammatory Bowel Disease.

Scheffers LE, Vos IK, Utens EMWJ, Dieleman GC, Walet S, Escher JC · Journal of pediatric gastroenterology and nutrition · 2023

Physical activity programs have been suggested as adjunctive therapy in adult inflammatory bowel disease (IBD) patients. We assessed the effects of a 12-week lifestyle intervention in children with IBD. This study was a randomized semi-crossover controlled trial, investigating a 12-week lifestyle program (3 physical training sessions per week plus personalized healthy dietary advice) in children with IBD. Endpoints were physical fitness (maximal and submaximal exercise capacity, strength, and core stability), patient-reported outcomes (quality of life, fatigue, and fears for exercise), clinical disease activity (fecal calprotectin and disease activity scores), and nutritional status (energy balance and body composition). Change in maximal exercise capacity (peak VO 2 ) was the primary endpoint; all others were secondary endpoints. Fifteen patients (median age 15 [IQR: 12-16]) completed the program. At baseline, peak VO 2 was reduced (median 73.3% [58.8-100.9] of predicted). After the

Dietary therapy for small bowel Crohn's disease.

Baharad Y, Engel T, Ben-Horin S · Current opinion in gastroenterology · 2026

This review highlights the emerging role of dietary interventions for Crohn's disease (CD). An overview of clinical data on dietary strategies for management of CD is presented, including exclusive enteral nutrition, the Crohn's disease exclusion diet (CDED) and the Mediterranean diet, among others. The methodological challenges in performing dietary randomized trials are outlined, including the difficulty in blinding, the multiple components inherent to food interventions and the heterogeneous nature of even 'similar' dietary constituents, collectively making it hard to delineate the responsible mechanism for any observed effect. We also review the data on food supplements explored for this CD treatment, such as vitamin D, omega-3 and combination curcumin-QingDai (CurQD). Novel strategies to integrate personalized nutrition with pharmacologic therapy are discussed and may ultimately improve disease control and patients' long term prognosis and quality of life. Dietary interventions a

Partial Enteral Nutrition in the Management of Crohn's Disease: A Systematic Review and Meta-Analysis.

Jatkowska A, White B, Gkikas K, Seenan JP, MacDonald J, Gerasimidis K · Journal of Crohn's & colitis · 2025

Exclusive enteral nutrition is an established treatment for active Crohn's disease but the role of partial enteral nutrition (PEN) in the broader management of the disease is less clear. This systematic review and meta-analysis reviewed the literature on the role of PEN in Crohn's disease management. This review was conducted following Cochrane recommendations. The protocol was registered on PROSPERO. Findings were reported following the PRISMA guidelines. Sixty-four articles were identified, of which 11 reported data from randomized control trials. Good quality evidence suggests that PEN may be used as a maintenance and induction therapy, particularly at high dosages and/or alongside exclusion diets. A higher dosage of PEN is associated with a lower risk of subsequent disease relapse, with benefits observed at intakes above 35% of energy requirements (35%-50% PEN: OR [95% confidence intervals (CI)]: 0.42 [0.27-0.65]; > 50% PEN: OR [95% CI]: 0.27 [0.08-0.88]). Low-qu

Comparative Efficacy of Advanced Therapies for Management of Moderate-to-Severe Crohn's Disease: 2025 AGA Evidence Synthesis.

Singh S, Murad MH, Yuan Y, Ananthakrishnan AN, Click B, Syal G · Gastroenterology · 2025

We performed an updated systematic review and network meta-analysis to inform the 2025 American Gastroenterological Association Clinical Guidelines on the management of moderate-to-severe Crohn's disease (CD). We searched multiple electronic databases from inception through August 14, 2024, to identify randomized controlled trials in adults with moderate-to-severe CD, comparing advanced therapies (eg, tumor necrosis factor antagonists, vedolizumab, interleukin 12/23, or interleukin 23p19 antagonists, and/or Janus kinase inhibitors) with placebo or another active comparator. Our primary outcomes were induction and maintenance of clinical remission; analyses were stratified by biologic therapy exposure status. We performed a network meta-analysis using a frequentist approach and applied the Grading of Recommendations, Assessment, Development and Evaluation to appraise certainty of evidence. We identified 28 trials of induction therapy and 22 trials of maintenance therapy of advanced th

MicroRNA-31 Reduces Inflammatory Signaling and Promotes Regeneration in Colon Epithelium, and Delivery of Mimics in Microspheres Reduces Colitis in Mice.

Tian Y, Xu J, Li Y, Zhao R, Du S, Lv C · Gastroenterology · 2019 · n=82

Levels of microRNA 31 (MIR31) are increased in intestinal tissues from patients with inflammatory bowel diseases and colitis-associated neoplasias. We investigated the effects of this microRNA on intestinal inflammation by studying mice with colitis. We obtained colon biopsy samples from 82 patients with ulcerative colitis (UC), 79 patients with Crohn's disease (CD), and 34 healthy individuals (controls) at Shanghai Tenth People's Hospital. MIR31- knockout mice and mice with conditional disruption of Mir31 specifically in the intestinal epithelium (MIR31 conditional knockouts) were given dextran sulfate sodium (DSS) or 2,4,6-trinitrobenzene sulfonic acid (TNBS) to induce colitis. We performed chromatin immunoprecipitation and luciferase assays to study proteins that regulate expression of MIR31, including STAT3 and p65, in LOVO colorectal cancer cells and organoids derived from mouse colon cells. Partially hydrolyzed alpha-lactalbumin was used to generate peptosome nanoparticles, and

Inflammatory Bowel Disease (IBD)

CDC

The CDC provides information on Inflammatory Bowel Disease (IBD), which includes Crohn's disease and ulcerative colitis. This resource offers statistics, public health data, and general information about these conditions.

Crohn's disease

NHS

The NHS provides official health information on Crohn's disease, detailing symptoms, causes, diagnosis, treatments, and advice for living with the condition. It serves as a key resource for the UK public.

Phase 2a Multicenter Randomized Double-Blind Placebo-Controlled Parallel Study to Evaluate the Efficacy and Safety of Oral PRV-6527 (JNJ-40346527), an Inhibitor of CSF-1 Receptor, in Subjects With Moderately to Severely Active Crohn's

n=93 · NCT03854305 · COMPLETED · COMPLETED

This study will evaluate the efficacy and safety of oral PRV-6527 in the treatment of moderately to severely active Crohn's disease

Stricture Definition and Treatment (STRIDENT) Drug Therapy Study

n=78 · NCT03220841 · UNKNOWN · UNKNOWN

Two thirds of patients with Crohn's disease require intestinal surgery at some time in their life. Intestinal strictures, that is narrowing of the bowel due to inflammation and scarring, are the most common reason for surgery. Despite the high frequency, associated disability, and cost there are no are no treatment strategies that aim to improve the outcome of this disease complication. The STRIDENT (stricture definition and treatment) studies aim to develop such strategies.

Quantitative Analysis of Lipid Mediators in Colonic Biopsies From Patients With Inflammatory Bowel Diseases and From Control Patients.

n=124 · NCT01990716 · COMPLETED · COMPLETED

We will quantify one of the lipid compounds (5,6 epoxy eicosatrienoic acid (5,6 EET), 5,6- EpoxyEicosaTrienoic acid) in colonic biopsies of Inflammatory Bowel Disease patients. We will evaluate its possible use as a pathological activity biomarker and its potential as a therapeutic target. We hypothesized that 5,6-EET is present in human colonic tissues in varying quantities depending on the pathological state of the IBD patient.

Cochrane reviews on Crohn's disease

Cochrane

Provides a collection of systematic reviews on various interventions and aspects of Crohn's disease. Cochrane reviews are renowned for their rigorous methodology and aim to summarize the best available evidence.

Crohn Disease

Natural Medicines Database

A comprehensive database providing evidence-based information on natural medicines, including herbs, supplements, and dietary interventions relevant to Crohn's disease. It covers efficacy, safety, and drug interactions.

Cochrane Library search for 'Crohn's Disease'

Cochrane

The Cochrane Library provides systematic reviews and meta-analyses of healthcare interventions, offering high-quality evidence for various aspects of Crohn's Disease. It is a critical resource for evidence-based medicine.