Crohn’s Disease: promising Hope for Treatment Cycles Dashed by Landmark CURE study
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New research presented at the European Gastroenterology Congress in Berlin reveals that stopping anti-TNF treatment in Crohn’s disease patients achieving early remission leads to high relapse rates, challenging the potential for cyclical therapy.
For years, clinicians and patients alike have hoped that Crohn’s disease, an inflammatory bowel disease frequently enough diagnosed in young adults, could be managed through carefully timed treatment cycles. The idea was that intense initial therapy could induce a deep remission, allowing for drug-free intervals. the Tract (GETAID), the CURE study aimed to definitively answer a critical question: could Crohn’s disease be effectively managed through treatment cycles? Researchers hypothesized that early, aggressive intervention could interrupt the inflammatory process and potentially allow for drug-free intervals.
“The idea was that, after the initial intense phase linked to a flare-up, the disease could subside, which would allow treatment to be reduced or even temporarily stopped if control was complete,” explained Professor David Laharie, president of GETAID. The study focused on patients newly diagnosed with Crohn’s disease – with an average diagnosis timeframe of just four months – representing an “early” form of the condition.
Between March 2015 and March 2019, 171 patients with an average age of 27 were treated with anti-TNF therapy, a first-line treatment for Crohn’s disease. The study initially assessed the rate of complete remission – encompassing clinical symptoms, biological markers, and endoscopic findings – one year after discontinuing treatment. The results were sobering: only 22.2% of patients achieved remission after one year on adalimumab.
Dismal Remission Rates After Treatment Cessation
The second, and perhaps more crucial, phase of the CURE study tracked how many patients maintained remission after stopping treatment. The findings were stark. After one year without adalimumab, a mere 4.1% of patients remained relapse-free.
“Maintaining remission after stopping treatment remains remarkable,” stated Dr. Bénédicte Caron, a hepato-gastroenterologist at CHRU Nancy. “Anti-TNF treatment must be continued over time, even in patients suffering from a recent form of the disease.”
According to Dr. Caron, “No longer taking medication once deep remission of the disease has been achieved exposes you to relapses, almost certainly.”
Rethinking Treatment Strategies
While the CURE study delivers a discouraging blow to the concept of treatment cycles, experts suggest the timeframe for evaluating remission might potentially be too short. Some propose extending the period of sustained remission to several years – potentially up to five – before considering a therapeutic break. However, they emphasize that any decision to discontinue treatment must be individualized and carefully considered.
The low remission rates observed in the study underscore the challenges of achieving lasting control of Crohn’s disease, even with effective therapies like anti-TNF. While the goal of cyclical treatment remains appealing,the CURE study provides compelling evidence that,for the vast majority of patients,continuous anti-TNF therapy is currently necessary to prevent relapse.
The study’s findings reinforce the importance of early diagnosis and consistent monitoring in managing Crohn’s disease and slowing its progression. Despite advancements in treatment, achieving the desired outcomes remains a notable hurdle, highlighting the need for continued research and innovation in the field of inflammatory bowel diseases.
Source: Suivi de la session de congrès et de l’étude B. Caron, E. Jeanbert,F. Poullenot, Y. et al.Changing the course of cRohn’s disease with an Early use of adalimumab: The CURE study from the GETAID; UEGW 2025, Berlin Sunday, October 5, 3.30pm – 3.42pm Session Clinical management of IBD; interview with Pr David Laharie (CHU de Bordeaux, 10/25).
Written by: Hélène Joubert – Edited by Emmanuel Ducreuzet.
