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Anti–interleukin-23 Medications and Durable Remission for Patients With Crohn's Disease

my little penguin

Moderator
Staff member
Per the article
They didn’t study the durable response or the any immunogenicity effects
They were doing a standard drug trial woth induction phase of the drug and then placebo vs receiving the drug
The placebo group did as well as the group continuing to receive the drug
That is not the same thing as a study of folks taking the drug for a while then stopping due to remission and seeing what happens /how long they last until flares start /what happens with surgery rates /what happens when they need to restart the drug does it still work .

lots of questions
Observational for now -would be nice if it did work
And a lot more studies need to be done
Also needs studies in kids since adult crohns behaves differently than those dx as children
 
This is very positive. It's really interesting that in these maintenance trials they're seeing that the people already induced with anti-IL23 are having high rates of continued remission after being switched to placebo. For some people, durable, drug-free remission isn't just a dream.
 
This is very positive. It's really interesting that in these maintenance trials they're seeing that the people already induced with anti-IL23 are having high rates of continued remission after being switched to placebo. For some people, durable, drug-free remission isn't just a dream.
It makes me wonder if these people are on some type of special diets while being med-free. Our dietitian said if she would only recommend CDED phase 3 (basically the maintenance phase) for anyone who wants to go off of med.
 

crohnsinct

Well-known member
In drug trials they generally make sure you aren’t on any other therapies that might skew results so I am guessing anyone on any special diets such as CDED, SCD etc would be excluded or asked to discontinue the diet.

The article does say that their theory is that the sequencing of anti tnf therapy followed by the IL therapy actually changes the cells and can lead to durable remission.

Makes me wonder more if a patient starts IL therapy how likely their prospects are for using it PRN vs a previous anti tnf user.

Also important to note that discontinuing therapy should not be attempted until they can identify who this subset of patients is and an early indicator of the return of inflammation. Fecal calprotectin is too late because it only registers high once inflammation is present and you don’t want that inflame/heal cycle repeating itself as that leads to scar tissue and cancer risk.

Interesting and encouraging research. Lots of research and development going on these days. I think we are going to see quite a shift in the next ten years.
 
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