Entering the era of disease modification in Crohn’s disease

INTRODUCTION: Crohn's disease (CD) can follow a progressive course leading to structural bowel damage and disability. The expansion of advanced therapies and recognition of a window of opportunity have shifted management from symptom control toward disease modification. AREAS COVERED: After searching MEDLINE and Embase from inception until 1 July 2027, we reviewed studies examining early intervention and disease modification in Crohn's disease. This review examines evidence for early medical and surgical intervention as individual treatment strategies to modify the course of disease, distinguishes short-term inflammatory control from durable alteration of disease course, and considers emerging strategies that target fibromuscular remodeling. We also address the heterogeneity of CD, the aspirations for precision approaches, and the challenges of implementing timely, personalized care. EXPERT OPINION: Early intervention and disease modification have evolved over time in Crohn's disease and that there is now a robust evidence-base to support the potential for disease modification in Crohn's disease, particularly with initiation of early effective intervention as soon as possible after diagnosis. Given the successes of early intervention, there is now increasing focus on the potential for preclinical intervention as a means to potentially prevent disease onset, reduce cumulative bowel damage, and avoid long-term disability.

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Publication Details

Journal
Expert Review of Clinical Pharmacology
Published
2026-09-18
DOI
https://doi.org/10.1080/17512433.2026.2737182
Primary Topic
Inflammatory Bowel Disease
Type
article
Field-Weighted Citation Impact
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article

Entering the era of disease modification in Crohn’s disease

Nathan Grellier, Marie Truyens, Piotr Eder, Nurulamin M Noor et al.
Expert Review of Clinical Pharmacology
Inflammatory Bowel Disease
article

Entering the era of disease modification in Crohn’s disease

Nathan Grellier, Marie Truyens, Piotr Eder, Nurulamin M Noor, K Karmiris, Joseph Sleiman, Ignacio Catalan-Serra, Lauranne A A P. Derikx, Mohammed Nabil Quraishi, Brigida Barberio, Sang Hyoung Park, Beatriz Gros
article en

Abstract

INTRODUCTION: Crohn's disease (CD) can follow a progressive course leading to structural bowel damage and disability. The expansion of advanced therapies and recognition of a window of opportunity have shifted management from symptom control toward disease modification. AREAS COVERED: After searching MEDLINE and Embase from inception until 1 July 2027, we reviewed studies examining early intervention and disease modification in Crohn's disease. This review examines evidence for early medical and surgical intervention as individual treatment strategies to modify the course of disease, distinguishes short-term inflammatory control from durable alteration of disease course, and considers emerging strategies that target fibromuscular remodeling. We also address the heterogeneity of CD, the aspirations for precision approaches, and the challenges of implementing timely, personalized care. EXPERT OPINION: Early intervention and disease modification have evolved over time in Crohn's disease and that there is now a robust evidence-base to support the potential for disease modification in Crohn's disease, particularly with initiation of early effective intervention as soon as possible after diagnosis. Given the successes of early intervention, there is now increasing focus on the potential for preclinical intervention as a means to potentially prevent disease onset, reduce cumulative bowel damage, and avoid long-term disability.

Expert Review of Clinical Pharmacology
Ulsan College (KR), Poznan University of Medical Sciences (PL), Cleveland Clinic (US), University of Padua (IT), University of Crete (GR), Radboud University Nijmegen (NL), Inserm (FR), Khalifa University of Science and Technology (AE), Norwegian University of Science and Technology (NO), University of Cambridge (GB), Akershus University Hospital (NO), Ghent University Hospital (BE), Cambridge University Hospitals NHS Foundation Trust (GB), University Medical Center (US), Radboud University Medical Center (NL), Sorbonne Université (FR), University of Ulsan (KR), Cambridge School (PT), Instituto Maimónides de Investigación Biomédica de Córdoba (ES), Sheikh Shakhbout Medical City (AE), Assistance Publique – Hôpitaux de Paris (FR), Hôpital Saint-Antoine (FR), Fédération Hospitalo-Universitaire, Paris Center for Microbiome Medicine (FR), Hospital Universitario Reina Sofía (ES), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (ES), Centre de Recherche Saint-Antoine (FR), University of Birmingham (GB), Rotterdam University of Applied Sciences (NL)
Good health and well-being
Openalex Percentile: Top 11%
Inflammatory Bowel Disease
DOISourceOpenAlex
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