Mucosal healing and inflammatory bowel disease: Therapeutic implications and new targets

Table 1 Summary of inflammatory bowel disease therapeutics

Treatment type	Available therapeutics	Mucosal healing relevance/ Success
Corticosteroids	Prednisone/ Prednisolone/ Methylprednisone	Prednisone treatment for 14 d (20 mg/day) decreased mucosal inflammation indicating a possible role in developing short-term MH[139]. 29% of patients in one study displayed endoscopic remission after steroid treatment[140].
Nutritional therapy	Enteral nutrition (EN)/ Partial enternal nutrition (PEN)	EN/PEN induce MH in both adults and children[14].
Aminosalicylates (5-ASA)	Sulfasalazine/ Mesalamine/ Olsalazine/ Balsalazide	On average induce MH in 43.7% of patients[141].
Immunomodulators	Azathioprine/ 6-mercaptopurine	Azathioprine alone has achieved MH in 16.5% of cases and in 43.9% when used in combination with antibody therapies[18]. After 16 wk of mercaptopurine treatment, patients in remission showed a 47.1% rate of MH[142].
	Cyclosporine	Shown to induce MH when used in conjunction with Vendolizumab[143].
	Tacrolimus	Shown to induce MH when used in conjunction with Vendolizumab[143].
	Methotrexate	After 36 wk, methotrexate treatment had a MH rate of 47.4%[142].
Monoclonal antibody/ Biologic therapies	Adalimumab	Induced MH in 24% of patients treated[24].
	Certolizumab	Clinical response rate at weeks 2 and 12 was 29.7% and 52.8% (respectively) in CD[25].
	Infliximab	Treatment induced MH in up to 60.3% of patients in phase 2 clinical trials[23].
	Natalizumab	MH achieved by 42.3% of patients after 14.1 mo of treatment[144].
	Risankizumab-rzaa	Endoscopic response and deep remission observed in 55% and 29% of patients (respectively), indicating MH[27].
	Ustekinumab	Treatment of individuals with moderate to severe CD showed MH via a reduced disease score after 8 wk[19].
	Vedolizumab	Has shown to induce MH in up to 50% of UC patients and 29% of CD patients in clinical trials[26,27].

MH: Mucosal healing; EN: Enteral nutrition; PEN: Partial enteral nutrition; 5-ASA: Aminosalicylates; CD: Chron’s Disease; UC: Ulcerative colitis.