Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Oct 10:17:261-315.
doi: 10.2147/CEG.S434014. eCollection 2024.

Refractory Crohn's Disease: Perspectives, Unmet Needs and Innovations

Luisa Bertin  1 , Martina Crepaldi  1 , Miriana Zanconato  1 , Greta Lorenzon  1 , Daria Maniero  1 , Caterina De Barba  1 , Erica Bonazzi  1 , Sonia Facchin  1 , Marco Scarpa  2 , Cesare Ruffolo  2 , Imerio Angriman  2 , Andrea Buda  3 , Fabiana Zingone  1 , Edoardo Vincenzo Savarino  1 , Brigida Barberio  1
Affiliations
Review

Refractory Crohn's Disease: Perspectives, Unmet Needs and Innovations

Luisa Bertin et al. Clin Exp Gastroenterol. .

Abstract

Crohn's disease (CD) is a complex, chronic inflammatory bowel disease characterized by unpredictable flare-ups and periods of remission. Despite advances in treatment, CD remains a significant health burden, leading to substantial direct healthcare costs and out-of-pocket expenses for patients, especially in the first-year post-diagnosis. The impact of CD on patients' quality of life is profound, with significant reductions in physical, emotional, and social well-being. Despite advancements in therapeutic options, including biologics, immunomodulators, and small molecules, many patients struggle to achieve or maintain remission, leading to a considerable therapeutic ceiling. This has led to an increased focus on novel and emerging treatments. This context underscores the importance of exploring advanced and innovative treatment options for managing refractory CD. By examining the latest approaches, including immunomodulators, combination therapies, stem cell therapies, and emerging treatments like fecal microbiota transplantation and dietary interventions, there is an opportunity to gain a comprehensive understanding of how best to address and manage refractory cases of CD.

Keywords: biologic drugs; combination therapy; fecal microbiota transplantation; hyperbaric oxygen therapy; medical therapy; mesenchymal stem cell therapy; perianal Crohn’s disease; refractory Crohn’s disease; small molecules.

PubMed Disclaimer

Conflict of interest statement

Edoardo Vincenzo Savarino has served as speaker for Abbvie, Agave, AGPharma, Alfasigma, Aurora Pharma, CaDiGroup, Celltrion, Dr Falk, EG Stada Group, Fenix Pharma, Fresenius Kabi, Galapagos, Janssen, JB Pharmaceuticals, Innovamedica/Adacyte, Malesci, MayolyBiohealth, Omega Pharma, Pfizer, Reckitt Benckiser, Sandoz, SILA, Sofar, Takeda, Tillots, Unifarco; has served as a consultant for Abbvie, Agave, Alfasigma, Biogen, Bristol-Myers Squibb, Celltrion, DiademaFarmaceutici, Dr. Falk, Fenix Pharma, Fresenius Kabi, Janssen, JB Pharmaceuticals, Merck & Co, Nestlè, Reckitt Benckiser, Regeneron, Sanofi, SILA, Sofar, Synformulas GmbH, Takeda, Unifarco; he received research support from Pfizer, Reckitt Benckiser, SILA, Sofar, Unifarco, Zeta Farmaceutici. Fabiana Zingone has served as a speaker for EG Stada Group, Fresenius Kabi, Janssen, Pfizer, Takeda, Unifarco, Malesci, and Kedrion and has served as a consultant for Galapagos. Brigida Barberio has served as a speaker for Abbvie, Agave, Alfasigma, AGpharma, Janssen, Lilly, MSD, Pfizer, Sofar, Takeda, and Unifarco. Edoardo Vincenzo Savarino and Brigida Barberio are co-senior authors. The other authors declare no conflict of interest.

Figures

None
Graphical abstract
See this image and copyright information in PMC

References

    1. Kaplan GG, Windsor JW. The four epidemiological stages in the global evolution of inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. 2021;18(1):56–66. doi:10.1038/s41575-020-00360-x - DOI - PMC - PubMed
    1. da Silva Júnior RT, Apolonio JS, de Souza Nascimento JO, et al. Crohn’s disease and clinical management today: how it does? World J Methodol. 2023;13(5):399–413. doi:10.5662/wjm.v13.i5.399 - DOI - PMC - PubMed
    1. Cassol OS, Zabot GP, Saad-Hossne R, Padoin A. Epidemiology of inflammatory bowel diseases in the state of Rio Grande do Sul, Brazil. World J Gastroenterol. 2022;28(30):4174–4181. doi:10.3748/wjg.v28.i30.4174 - DOI - PMC - PubMed
    1. Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017;390(10114):2769–2778. doi:10.1016/S0140-6736(17)32448-0 - DOI - PubMed
    1. Kaplan GG, Bernstein CN, Coward S, et al. The impact of inflammatory bowel disease in Canada 2018: epidemiology. J Can Assoc Gastroenterol. 2019;2(Suppl 1):S6–S16. doi:10.1093/jcag/gwy054 - DOI - PMC - PubMed

LinkOut - more resources