A New Target for Crohn’s Disease: The Promise of Transmural Healing
A major new clinical trial, VECTORS, is investigating whether targeting “transmural healing” (TMH)—the resolution of inflammation through the entire intestinal wall, as assessed by ultrasound—is superior to targeting only clinical and biomarker remission in patients with moderately to severely active Crohn’s disease. This phase 4, randomized controlled trial will enroll approximately 304 patients internationally, treating them with vedolizumab and using a structured escalation algorithm to achieve their assigned treatment goal. The primary objective is to determine if the TMH-targeted approach leads to better corticosteroid-free endoscopic remission at 48 weeks, with long-term complications assessed at 96 weeks.
Why it might matter to you: This trial represents a significant shift in treatment paradigms for a chronic inflammatory condition, moving beyond surface-level endoscopic assessment to a deeper, transmural target. For professionals focused on infection control and host-pathogen interactions, the study’s framework for defining and aggressively treating a “healed” state offers a parallel model for managing complex, persistent biological threats. Its findings could influence how treatment targets are defined not just in gastroenterology, but in other fields where achieving a fundamental biological resolution is critical to preventing long-term complications and recurrence.
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