A Multipronged Approach to IBD

Mount Sinai has been at the forefront of inflammatory bowel disease (IBD) research and treatment for almost a century, since our own Burrill B. Crohn, MD, first described the disease that now bears his name in a seminal 1932 paper. In that time, we’ve learned a lot about both pharmacologic and non-pharmacologic approaches to the disease, and we focus on both in this year’s Specialty Report.

We launched a new study in Crohn’s disease that combines traditional biologic therapy with brain-gut behavior therapy to increase psychological flexibility and resilience. We hope that addressing these needs will help break through the ceiling we’ve reached with current immunosuppressive medications for Crohn’s disease.

This study also includes a nutrition component, and in a separate, first-of-its-kind program, we are offering Crohn’s disease and ulcerative colitis (UC) patients a full range of nutrition-focused clinical and research initiatives. They include a multidisciplinary malnutrition specialty outpatient clinic, a dedicated inpatient IBD nutrition team, an active research initiative that has already shown highly favorable patient outcomes from its screening and intervention model, and a weight management program.

Pregnancy adds another layer of complexity to IBD care, and we are launching an ambitious study to provide accurate and high-quality data for counseling IBD patients on the impact that factors such as surgery, medications, and disease activity might have on their ability to conceive. Under Mount Sinai’s leadership, some 30 sites across the country are now recruiting women with IBD who are planning to become pregnant.

On the pharmacologic side, we recently published a study showing that tulisokibart, a first-in-class monoclonal antibody therapy that targets TL1A, proved effective in a phase 2 trial in inducing clinical remission in UC patients who had not responded to other treatments. Another paper proposed a mechanism for action for vedolizumab. This mainstay UC therapy appears to work by preventing white blood cells from entering gut-associated lymphoid tissue, a finding that could lead to new biomarkers and therapies.

We helped conduct a study showing that a multi-target stool-based DNA test to detect colorectal cancer that has become commercially popular offers promise as a complement to colonoscopic surveillance for dysplasia in patients with UC and Crohn’s disease.

Unfortunately, despite several years of attention, health equity is still a significant issue in this country. To address it, we recently launched a program called Health Equity in Action for Liver and Digestive Diseases (HEALD) to identify and address disparities across racial, ethnic, and socioeconomic backgrounds. Its founder, Pascale M. White, MD, MBA, MS, FACG, is starting with a focus on colorectal cancer screening and, in partnership with her colleagues in the Division of Liver Diseases, hepatitis B and C screening.

My best wishes to you for 2025. I hope you find this report informative and useful in your clinical and research endeavors.