Advancements in Immunomodulatory Therapies for IBD and Their Interplay With the Gut–Brain Axis: An Updated Review of Current Literature and Beyond

Recent advancements in immunomodulatory therapies have significantly improved patient outcomes. Biological agents such as infliximab and vedolizumab have demonstrated remission rates of 40%-69% in IBD patients, with infliximab reducing colectomy. Rates to 10% at 54 weeks. Meanwhile, fecal microbiota transplantation (FMT) has emerged as a promising therapy for ulcerative colitis, with trials reporting 87.1% clinical remission at 48 weeks compared to 66.7% in the placebo group, along with higher endoscopic and histological remission rates. A trial on multidonor-intensive FMT found a 27% clinical remission rate at week 8, significantly higher than 8% in the placebo group, reinforcing its potential as an adjunct therapy in IBD. By examining their interplay with the gut-brain axis, this review provides insights into the mechanisms and clinical relevance of these therapies, paving the way for more targeted and effective IBD management strategies.