Researchers take major strides in treating Crohn’s disease


There is a need for more patient-oriented treatments

Researchers from Amsterdam UMC and other European hospitals, together with various companies and patient organizations, have drawn up a revolutionary plan for the treatment of Crohn’s disease. The best treatment is selected based on analysis of the structure of a patient’s DNA. This is of great importance for the many patients with Crohn’s disease, who suffer from chronic intestinal inflammation and complaints such as diarrhea, abdominal pain and weight loss.

The research, led by professors Geert D’Haens and Wouter de Jonge, is funded by a prestigious grant from the European Union (Horizon Europe) of more than 10 million euros. The study points to major advances in the treatment of Crohn’s disease. Researchers from Amsterdam UMC and colleagues in Oxford have discovered that certain elements present on a patient’s DNA (so-called methylation markers) can predict whether a patient will respond to a particular treatment. This is important because the vast majority (more than 60%) of patients with Crohn’s disease do not respond properly to the available modern treatments (protein-neutralizing drugs; so-called biologicals). Moreover, it is currently impossible to predict which treatment will be most effective. This leads to incomplete treatment of the patients which can cause the disease to flare up and which can also lead to complications that often require surgery. This increases the patient’s disease burden and also leads to high social costs. There is a need for more patient-oriented treatments by predicting which treatment a patient will respond to best, also known as ‘personalized medicine’.

Trial with 400 patients
In the preliminary work, an extensive and complicated analysis was used, which is not very effective clinically. The researchers are now going to develop a rapid test together with various companies and patient organizations. In the next phase, this test will be used in a clinical trial with 400 patients with Crohn’s disease. The test is based on the analysis of specific structures on the DNA in a patient’s blood, known as methylation. That test can predict which treatment will work best for this patient, and then the patient gets that therapy. For comparison, a group of identical patients is treated in the usual way, without using the test. In this way it can be determined whether the test leads to more effective treatments.

Also for patients with rheumatism or psoriasis
During the study, comparable data will also be collected from patients with rheumatism or the skin disease psoriasis, so that this test can also be developed for these patient groups in the future. The study, called METHYLOMIC, will start in January 2023 in a large number of European hospitals and will take four years to complete. Evidence that the test works in clinical practice would be a major improvement for patients with Crohn’s disease and, in the future, for patients with other inflammatory diseases.

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Major Advance in Crohn’s Disease Treatment
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