There are now several classes of targeted drugs, but each brings lasting remission to only a minority, and people often cycle through them. Research is aimed at a new target, pills in place of injections, and using two drugs together.
- 497studies open or running
- 46of them in phase 3
- 3,414papers published this year
- 135NIH-funded projects
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Now
Nov 2026
Guselkumab closes fistulasHappened 28.3% vs 10.3% fistulas closed at 24 weeks
In a dedicated phase 3 trial, guselkumab fully closed fistulas far more often than placebo.
28.3% vs 10.3%: had fistulas fully closed at 24 weeks, guselkumab vs placebo.
A new drug class reaches phase 3Happened 26% vs 12% gut healing, early study
Three antibodies against TL1A are in large Crohn's trials after promising early results.
26% vs 12%: had visible gut healing on tulisokibart, against the rate expected without it.
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6 months
by May 2027
Obefazimod pill, mid-stage resultPossible
A once-daily pill tested in 212 people; the trial finishes in December 2026.
Two antibodies togetherPossible
A 703-person trial of guselkumab plus golimumab is fully enrolled and past its completion date.
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12 months
by Nov 2027
Vedolizumab plus upadacitinibPossible
A 396-person trial of starting two approved drugs together finishes in June 2027.
One-year fistula dataLikely 28.3% vs 10.3% closed at 24 weeks
Longer follow-up shows whether fistulas closed by guselkumab stay closed.
28.3% vs 10.3%: had fistulas fully closed at 24 weeks, guselkumab vs placebo.
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3 years
by late 2029
First TL1A phase 3 resultsLikely 26% vs 12% gut healing, early study
Tulisokibart in 1,200 people finishes in October 2028; afimkibart follows that December.
26% vs 12%: had visible gut healing on tulisokibart, against the rate expected without it.
An IL-23 blocker as a pillLikely
Icotrokinra, a once-daily pill, in 1,092 people finishes in September 2028.
Two leading drugs compared directlyPossible
Guselkumab against risankizumab in 530 people finishes in November 2028.
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5 years
by late 2031
A drug that prevents scarringLong shot 26% vs 12% gut healing, early study
If TL1A antibodies reduce narrowing of the gut, fewer people would need surgery.
26% vs 12%: had visible gut healing on tulisokibart, against the rate expected without it.
Starting with two drugsLong shot
Combination treatment from the start becomes a standard choice for severe disease.
Choosing the drug by testLong shot
Genetic and tissue markers tell which drug a person will respond to before trying it.
The research paths
TL1A antibodies
26% vs 12% gut healing, early studyDetails and 3 trialsHide
A new target that drives both inflammation and scarring. Three companies are running large trials.
WatchWhether results are better in people who test positive for a matching genetic marker.
Pills in place of injections
Details and 4 trialsHide
Most targeted Crohn's drugs are infusions or injections. Several once-daily pills are in trials.
WatchIcotrokinra, the largest.
Two drugs together
Details and 3 trialsHide
Combining drugs that work differently, to get past the ceiling each one hits alone.
WatchInfections, the main risk of doubling up.
Fistulas
28.3% vs 10.3% fistulas closed at 24 weeksDetails and 1 trialsHide
Fistulas have had few proven drug treatments. Guselkumab now has a positive dedicated trial.
WatchOne-year durability.
Which drug first
Details and 2 trialsHide
Head-to-head trials between approved drugs, which companies rarely ran in the past.
WatchGuselkumab against risankizumab.
Borrowed from other conditions
From Psoriasis
Guselkumab
28.3% vs 10.3% fistulas closed
Approved for Crohn's
An IL-23 blocker first approved for psoriasis, now shown to close Crohn's fistulas.
From Diabetes and obesity
Tirzepatide
Phase 3
The weight-loss injection, added to mirikizumab in people with Crohn's and obesity.
From Psoriasis
Icotrokinra
Phase 3
A pill that blocks the IL-23 receptor, developed first for psoriasis.
From Rheumatoid arthritis
Upadacitinib
Approved; combination in phase 3
A JAK-blocking pill from arthritis care, now tested in combination with vedolizumab.
Open to join now
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Moderate to severe Crohn's
Tulisokibart (TL1A antibody)
Locations and eligibility → -
Moderate to severe Crohn's
Duvakitug (TL1A antibody)
Locations and eligibility → -
Moderate to severe Crohn's
Icotrokinra pill (ICONIC-CD)
Locations and eligibility → -
Moderate to severe Crohn's
Afimkibart (TL1A antibody)
Locations and eligibility → -
Moderate to severe Crohn's
Guselkumab vs risankizumab (CHARGE)
Locations and eligibility → -
Moderate to severe Crohn's
Vedolizumab plus upadacitinib
Locations and eligibility →
See every recruiting Crohn's trial →
When the large trials finish
Completion dates the trials registered. Results usually follow 3 to 12 months later.
- Heating up
- Maturing
- Early
- Cooling
- Fully enrolled, waiting on results
- Still enrolling
Knowledge on the way
Not treatments yet: detection, causes and how care is delivered. Mostly NIH-funded.
- AreaQuestionFunded throughNews likely
- Causes Gut bacteria enzymes that calm inflammationStanford University · NIH Funded through Aug 2030 News likely 2028–2030
- Causes Genetics to match people to treatmentsMount Sinai · NIH Funded through Jun 2027 News likely 2027–2028
- Causes Mapping which gut cells drive inflammation, and whenBroad Institute · NIH Funded through May 2028 News likely 2027–2028
- Detection Are random biopsies needed for cancer checks in bowel disease?University of Pennsylvania · NIH Funded through Jun 2029 News likely 2028–2029
- Care Outcomes for children newly diagnosed with Crohn'sConnecticut Children's · NIH Funded through Mar 2028 News likely 2027–2028
What just happened
Guselkumab closes fistulas in phase 3
28.3% vs 10.3% with placebo at 24 weeks.
TL1A antibodies: first phase 3 win claimed in ulcerative colitis
Announced by the company without data; Crohn's trials are still running.
Standard treatment today
- Mild diseaseBudesonide for flares, with monitoring.
- Moderate to severeA targeted drug started early: an anti-TNF, an IL-23 blocker (risankizumab, guselkumab, mirikizumab), ustekinumab, vedolizumab, or the pill upadacitinib.
- FistulasInfliximab, with surgery and antibiotics as needed.
- Narrowing or blockageEndoscopic stretching or surgery. No drug reverses scarring.
How to read this page, and sourcesHow to read this page, and sources
- The early TL1A figure compares against a historical rate, not a placebo group.
- Fistula results are for 24 weeks only.
- Completion dates are what each trial registered. Results usually follow 3 to 12 months later.
- Forecasts are editorial judgments by Find a Trial, not predictions from sponsors or regulators.
See Crohn's trials recruiting now →