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VIDEO: Novel Therapies Needed for Crohn's Stricturing
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CLEVELAND — In this exclusive video from the Cleveland Clinic Inflammatory Bowel Disease Master Class, Florian Rieder, MD, from Cleveland Clinic, discusses the lack of anti-fibrotic therapies that could potentially help stricturing in Crohn’s disease.
“More than 30% of patients with Crohn’s disease develop this complication over time that presents with intestinal obstruction, abdominal pain, abdominal cramping and often makes surgical intervention necessary,” Rieder told Healio Gastroenterology and Liver Disease. “This is not only a problem in Crohn’s disease but also a problem in ulcerative colitis where you find fibrosis in 100% of colectomy specimens of patients with ulcerative colitis.”
Although there is a clear link between the severity of inflammation and fibrosis, Rieder said suppressing the inflammation does not treat intestinal strictures. That leaves investigators to look for other targets to help with stricture prevention.
New research has focused on new areas, including the gut microbiota, “creeping fat,” and the exo-cell environment. Rieder said research has been limited by the lack of clinical endpoints, but the GI community has been working to develop new measurements that could lead to more trials for fibrosis in CD.
“Stricturing in Crohn’s disease is a very complex process,” Rieder said. “We need novel therapies and we are currently developing a pathway to allow testing of novel therapies in this clinical setting.”
Disclosure: Rieder reports serving as a consultant for Allergan, AbbVie, BoehringerIngelheim, Celgene, Cowen, Gilead, Gossamer, Helmsley, Janssen, Koutif, Pliant, Pfizer, Receptos, RedX, Roche, Samsung, Takeda, Thetis and UCB.