If you’re living with Crohn’s disease, you know the exhausting cycle all too well: inflammation flares, pain strikes, and over time, that chronic inflammation can lead to something even more challenging—scar tissue that narrows your intestines. For those dealing with stricturing Crohn’s, it often feels like you’re fighting a war on two fronts, with current treatments only addressing half the battle.

But what if there was a treatment designed to tackle both problems at once? Recent news suggests that day might be closer than we think, and it could represent a fundamental shift in how we approach one of Crohn’s most challenging complications.

Summary of Quiverquant

Palisade Bio has launched a Phase 1b clinical trial for PALI-2108, a first-of-its-kind treatment candidate for fibrostenotic Crohn’s disease. Unlike current therapies that focus solely on reducing inflammation, PALI-2108 is designed as a dual-acting drug that targets both inflammation and fibrosis—the scar tissue formation that causes intestinal narrowing and strictures.

The study will enroll patients who are candidates for biologic therapy, with researchers evaluating the drug’s safety, how the body processes it, and early signs of effectiveness. The ultimate goal is to not only manage immediate symptoms but potentially prevent or even reverse the stricturing process that often leads to multiple surgeries and hospitalizations for Crohn’s patients.

This post summarizes reporting from Quiverquant. Our analysis represents IBD Movement’s perspective and is intended to help patients understand how this news may affect them. Read the original article for complete details.

What This Means for the IBD Community

Let’s be honest—when you hear about another clinical trial, it’s natural to feel a mix of hope and skepticism. We’ve all been disappointed before. But this particular development deserves our attention because it addresses a gap that many of us have experienced firsthand.

Current Crohn’s treatments, including biologics like Humira, Remicade, and newer options like Stelara, are incredibly effective at controlling inflammation. For many people, they’re absolute game-changers that restore quality of life. But here’s the frustrating reality: even when these medications successfully quiet the inflammatory process, they don’t necessarily address the scar tissue that may have already formed from years of previous inflammation.

This is why some patients find themselves in the peculiar situation of having well-controlled Crohn’s on paper—normal inflammatory markers, good colonoscopy results—but still dealing with stricture-related symptoms like cramping after meals, food getting “stuck,” or that familiar fear of blockages. It’s like trying to drive through a tunnel that’s been partially collapsed; even though no new damage is occurring, you’re still dealing with the narrowed space.

PALI-2108’s dual approach could potentially change this dynamic entirely. By simultaneously targeting both active inflammation and the fibrotic (scar tissue) process, it might offer hope for people who feel stuck between flares and strictures.

The Surgery Question

For many in our community, the word “stricture” is synonymous with “surgery.” Bowel resections, while often necessary and ultimately helpful, come with their own set of challenges—recovery time, potential complications, and the reality that Crohn’s can potentially affect the surgical site or other areas down the line.

A treatment that could prevent or reverse stricture formation might significantly reduce the need for surgical interventions. This doesn’t mean surgery would become obsolete—it will always be an important tool in managing Crohn’s—but having a medical option for stricturing disease could give patients and doctors more choices in treatment planning.

Think about what this could mean for newly diagnosed patients or those in the early stages of stricturing disease. Instead of the current approach of “control inflammation and hope we can delay surgery,” there might be a path toward actually reversing the narrowing process.

Questions to Consider

As exciting as this development is, it’s still early days. Here are some questions you might want to discuss with your gastroenterologist as this research progresses:

• If you have stricturing Crohn’s, how is it currently being monitored and managed?
• What are your current symptoms related to strictures, and how might a dual-acting treatment fit into your care plan?
• If you’re considering surgery for strictures, what’s the timeline, and might waiting for more data on treatments like PALI-2108 be appropriate?
• How might this type of treatment interact with your current Crohn’s medications?

The Broader Picture

This trial represents something we’re seeing more of in IBD research: precision medicine approaches that target specific aspects of the disease process. Rather than the one-size-fits-all approach of early Crohn’s treatment, we’re moving toward therapies designed for specific presentations and complications.

We’ve already seen this with treatments like vedolizumab (Entyvio) for gut-specific inflammation, and JAK inhibitors for patients who don’t respond well to biologics. PALI-2108 continues this trend by specifically addressing the fibrostenotic phenotype—the stricturing form of Crohn’s that affects a significant portion of patients over time.

It’s also worth noting that this research could have implications beyond Crohn’s disease. Fibrosis is a problem in many conditions—from liver disease to lung conditions—and insights gained from studying anti-fibrotic treatments in IBD might benefit patients with other conditions as well.

While we wait for results from this Phase 1b trial, it’s important to manage expectations appropriately. Early-phase trials are primarily about safety, and it will likely be several years before we know whether PALI-2108 will make it through all phases of clinical testing and potentially reach patients. But the very fact that researchers are thinking differently about stricturing Crohn’s—moving beyond “inflammation management” to “tissue remodeling”—suggests we’re entering a new era of treatment possibilities.

For patients currently dealing with stricturing disease, this news offers something precious: hope that the future might hold better options. And for those newly diagnosed or in remission, it suggests that the trajectory of Crohn’s disease might be changeable in ways we haven’t seen before.

The road from clinical trial to approved treatment is long and uncertain, but innovative approaches like PALI-2108 remind us that researchers are listening to what patients need most: treatments that don’t just manage symptoms, but actually change the course of the disease itself. In a condition where we’ve often had to accept compromise—trading one set of challenges for another—the possibility of a treatment that addresses multiple problems simultaneously feels genuinely revolutionary.

IBD Movement provides information for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.