Where does the therapy stand today?
Crohn’s disease is a chronic inflammatory disease of the entire gastrointestinal tract. Even today, the disease is considered incurable, although it can usually be well controlled by modern drugs. Where only a few decades ago patients could be treated with cortisone alone, today it is possible to specifically dampen the body’s inflammatory reactions with immunomodulators such as ciclospoprin A or tacrolimus or even with ultra-modern antibodies such as adalimumab or trastuzumab.
In this way, it is possible for most patients to achieve an almost normal quality of life and an undiminished life expectancy. In addition, the drugs used for treatment today, when used correctly, have far fewer side effects than the lifelong cortisone therapy used to be the norm. However, a cure for the disease is still not possible – only the control of its symptoms.
What can be achieved with the therapy?
Four out of five patients are able to lead a largely normal life under specialist medical treatment. The typical symptoms such as diarrhea or abdominal pain can usually be treated well, so that there is no reduction in quality of life during the relapse-free period. The occurrence of new relapses can also be prevented relatively well for many patients.
Nevertheless, current medications only weaken the inflammation in the gastrointestinal tract and thus also the resulting symptoms. The actual cause of the inflammation, however, is still not known. Therefore, a causal therapy of the disease and thus its cure are currently not possible even with the most modern drugs.
Will Crohn’s disease ever be curable?
In order to have a chance of curing a disease, its causal cause must first be clarified. However, despite intensive research efforts of many universities around the world, this has not been found until today. What is certain is that Crohn’s disease is not a purely hereditary disease.
Nevertheless, the genes play a major role, and the inherited proportion (so-called “concordance rate”) of the disease could be determined to be 60 – 70% in twin studies. This also means, however, that about 30 – 40% of the origin of the disease is due to external influences. What is certain, therefore, is that the development of Crohn’s disease is an extremely complex process that will take many decades to research. It is possible, but unlikely, that there will ever be a drug that cures the disease forever. Diseases such as Crohn’s disease, which are caused by the interaction of genes and the environment (so-called “multifactorial diseases”), cannot be treated causally with the current state of medical knowledge.
