IBD Journal Scan

Key articles from high impact journals in last month

Editorial Recommendations
JULY - 2024

Herbal Remedy CurQD Shows Promise in Treating Ulcerative Colitis
A recent study evaluated the effectiveness of a curcumin-QingDai (CurQD) herbal combination in patients with active ulcerative colitis (UC). In an open-label trial, 7 out of 10 patients responded positively, with 3 achieving clinical remission. In a subsequent placebo-controlled trial across Israel and Greece, 43% of CurQD-treated patients reached the primary outcome versus 8% on placebo. Clinical response and remission were significantly higher in the CurQD group, with 85.7% responding and 50% achieving remission compared to 30.7% and 8% with placebo, respectively. CurQD also led to greater endoscopic improvement and fecal calprotectin reduction. Notably, CurQD up-regulated mucosal CYP1A1 expression, indicating potential new treatment pathways. By week 16, 93% of CurQD patients maintained clinical response. These findings suggest CurQD as a promising therapeutic option for UC, warranting further investigation into the aryl-hydrocarbon receptor pathway.

Theracurmin®: A Promising New Ally in the Fight Against Crohn's Disease
A groundbreaking study reveals that Theracurmin®, a curcumin derivative with 27 times higher absorption than natural curcumin, shows significant efficacy and safety in treating Crohn's disease. Conducted across five medical centers in Japan, this randomized, double-blind trial administered Theracurmin® or placebo to patients with active mild-to-moderate Crohn's disease for 12 weeks. Results demonstrated a substantial reduction in clinical disease activity, with clinical remission rates in the Theracurmin® group reaching 40% by week 12, significantly higher than the placebo group. Endoscopic severity and anal lesions also improved notably in the Theracurmin® group. Importantly, no serious adverse events were reported. These findings suggest Theracurmin® as a powerful new treatment option for Crohn's disease, meriting further investigation.

Acupuncture Shows Promise in Treating Crohn's Disease
A recent 48-week study has revealed that acupuncture significantly improves symptoms and reduces inflammation in Crohn's disease (CD) patients. Conducted at a tertiary outpatient clinic in China, this randomized, sham-controlled trial included 66 patients with mild to moderate active CD unresponsive to drug treatment. Patients were randomly assigned to receive either acupuncture with moxibustion or a sham treatment for 12 weeks, followed by a 36-week follow-up. The acupuncture group exhibited a 42.4% higher clinical remission rate and a 45.5% higher clinical response rate than the sham group at week 12, with these benefits persisting through week 48. Additionally, this group showed decreased CD activity index, C-reactive protein levels, and recurrence rates, alongside increased beneficial gut bacteria. The findings suggest that acupuncture can effectively induce and maintain remission in CD patients by enhancing the intestinal barrier and regulating inflammatory cytokines.

Neuromodulation Therapies Offer New Hope for Inflammatory Bowel Disease
A systematic review reveals that neuromodulation therapies, specifically vagus nerve stimulation (VNS) and sacral nerve stimulation (SNS), show promise in treating inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis. Analyzing five clinical studies—three on VNS and two on SNS—researchers found significant improvements in IBD symptoms, such as disease activity, intestinal lesion severity, and pain. Both VNS and SNS reduced biomarkers of intestinal mucosal inflammation and mitigated sympathetic dominance without causing long-term adverse effects. These findings suggest that VNS and SNS could be effective, individualized treatment options for IBD, targeting key underlying pathophysiologies.

Hyperbaric Oxygen Therapy: A Promising Solution for Fistulizing Crohn's Disease
A new systematic review and meta-analysis highlight the potential of hyperbaric oxygen therapy (HBOT) in treating fistulizing Crohn's disease (CD). HBOT, which delivers 100% oxygen in a pressurized chamber to enhance tissue oxygen levels and regulate inflammation, showed an impressive overall clinical response rate of 87% across 16 studies involving 164 patients. Clinical remission was achieved in 59% of cases. Notably, perianal, enterocutaneous, and rectovaginal fistulas had response rates of 89%, 84%, and 29%, respectively. The analysis found no correlation between the number of HBOT sessions or hours in the chamber and the clinical response, and the adverse event rate was low at 51.7 per 10,000 sessions. Despite some study biases, these findings underscore HBOT's efficacy and safety as a promising treatment for fistulizing CD.

Hyperbaric Oxygen Therapy Shows Promise for Treating IBD
Emerging evidence indicates that hyperbaric oxygen therapy (HBOT) could benefit patients with inflammatory bowel disease (IBD). A systematic review and meta-analysis examined 18 studies, revealing an overall response rate of 83.24% for ulcerative colitis and 81.89% for Crohn's disease. While results varied for HBOT as an adjunct therapy in ulcerative colitis, significant healing rates were observed in fistulizing Crohn's disease, with complete healing in 47.64% of cases and partial healing in 34.29%. Most adverse events were minor. These findings suggest that HBOT may be effective for IBD flares, though larger randomized trials are needed to confirm its efficacy.

Probiotics Rival Standard Drug in Keeping Ulcerative Colitis in Remission
A study comparing the probiotic Escherichia coli Nissle 1917 to the established therapy mesalazine shows promising results for maintaining remission in ulcerative colitis. In a 12-month, double-blind trial involving 327 patients, participants received either the probiotic (200 mg once daily) or mesalazine (500 mg three times daily). Clinical and endoscopic activity indices and histology assessments confirmed equivalent efficacy: 36.4% of patients in the probiotic group and 33.9% in the mesalazine group experienced relapses (p = 0.003). No significant differences were observed in disease duration, localization, or pretrial treatment. Both treatments were well-tolerated with excellent safety profiles. These findings highlight the probiotic E coli Nissle 1917 as an effective alternative to mesalazine, emphasizing the crucial role of enteric flora in ulcerative colitis.