Crohn's disease affects over 115,000 people in the UK and is one of the two main forms of inflammatory bowel disease (IBD). It is a chronic, relapsing condition with no cure — but the treatment landscape is evolving rapidly. Biologics, JAK inhibitors, stem cell therapies, and precision medicine approaches are transforming what is possible. Here is what is actively recruiting in UK clinical trials.
The UK has one of the highest IBD rates in the world, and correspondingly strong research infrastructure. The IBD BioResource — a national cohort of over 40,000 patients — provides a powerful platform for recruiting into clinical trials.
Currently there are over 120 actively recruiting Crohn's disease trials in the UK. The field is moving from broad immunosuppression towards targeted therapies that modulate specific inflammatory pathways, with the goal of achieving mucosal healing — not just symptom control.
Biologic Therapy Trials
Biologics are now the standard of care for moderate-to-severe Crohn's disease, and new agents continue to emerge:
Anti-TNF agents — next-generation anti-TNF drugs and biosimilar trials (infliximab and adalimumab biosimilars)
Anti-integrin therapy — vedolizumab and next-generation gut-selective agents that target inflammation only in the digestive tract
Anti-IL-12/23 — ustekinumab and newer agents targeting the IL-12 and IL-23 inflammatory pathways
Anti-IL-23 (next-generation) — risankizumab, guselkumab, and mirikizumab showing superior efficacy in Crohn's disease
TNF-free combinations — trials combining non-anti-TNF biologics for patients who have failed anti-TNF therapy
A major focus is treat-to-target — using objective measures (endoscopy, calprotectin, CRP) rather than symptoms alone to guide treatment decisions.
JAK Inhibitors and Small Molecules
Oral small molecules offer an alternative to biologic injections and infusions:
Upadacitinib — approved for Crohn's, with ongoing trials in earlier treatment lines and combination therapy
Next-generation JAK inhibitors — more selective agents that target specific JAK subtypes to improve safety while maintaining efficacy
Sphingosine-1-phosphate (S1P) modulators — oral drugs that trap lymphocytes in lymph nodes, preventing them from reaching the gut
Tyrosine kinase inhibitors — targeting specific kinases involved in gut inflammation
Fistulising Crohn's Disease
Fistulas are one of the most challenging complications of Crohn's disease, affecting up to 50% of patients. UK trials for fistulising disease include:
Stem cell injections — injecting expanded allogeneic stem cells directly into fistula tracts to promote healing (the ADMIRE-CD trial lineage)
Novel biologic combinations — combining anti-TNF with other biologics specifically for fistula closure
Fibrin glue and plug devices — medical devices designed to seal fistula tracts
Local drug delivery — topical treatments applied directly to the fistula
Stem Cell Therapy
Beyond fistula treatment, stem cell approaches are being explored for Crohn's disease itself:
Autologous haematopoietic stem cell transplantation (HSCT) — essentially resetting the immune system in severe, treatment-resistant Crohn's. UK centres have been pioneers in this approach
Mesenchymal stem cells — IV-administered stem cells that modulate the immune response and promote tissue repair
Stem cell-derived exosomes — cell-free therapy using the signalling vesicles that stem cells produce
Diet and Microbiome Trials
The role of diet and the gut microbiome in Crohn's disease is an expanding research area:
Exclusive enteral nutrition (EEN) — liquid diet therapy, particularly for children and adolescents
Specific carbohydrate diet (SCD) — trials testing whether restrictive carbohydrate diets can maintain remission
Faecal microbiota transplantation (FMT) — transferring healthy gut bacteria from donors to patients
Prebiotic and probiotic trials — targeted microbial therapies to restore a healthy gut ecosystem
Dietary fibre interventions — exploring whether specific fibre types can reduce inflammation
Precision Medicine
The future of Crohn's treatment lies in matching the right treatment to the right patient:
Pharmacogenomics — using genetic testing to predict which drugs will work best for individual patients
Therapeutic drug monitoring — measuring drug levels and anti-drug antibodies to optimise dosing
Biomarker-guided therapy — using calprotectin, CRP, and endoscopic scores to guide treatment escalation and de-escalation
Multi-omic profiling — combining genomics, transcriptomics, proteomics, and microbiome data to build personalised treatment profiles
Eligibility and Biomarkers
Crohn's disease trials typically require:
Confirmed diagnosis of Crohn's disease (endoscopy and histology)
Active disease as measured by objective markers — elevated CRP, faecal calprotectin, or endoscopic disease activity
Documented treatment history — which biologics and immunosuppressants you have tried and failed
Disease location — ileal, colonic, or ileocolonic (Montreal classification)
Complication status — stricturing, fistulising, or non-stricturing/non-penetrating
For biologic trials: washout period from previous biologic therapy (varies by trial)
💡 Gather Your IBD Records
Before searching for Crohn's trials, collect: your most recent colonoscopy results, faecal calprotectin level, CRP, current medications and doses, history of biologics you have tried, and any fistula or stricture documentation. These are the key eligibility checkpoints for most trials.
UK Trial Centres
Major UK IBD trial centres include:
London — Royal London Hospital, St Mark's Hospital, Guy's and St Thomas', UCLH
Oxford — John Radcliffe Hospital, Oxford University Hospitals (IBD BioResource hub)
Cambridge — Addenbrooke's Hospital
Glasgow — Glasgow Royal Infirmary
Edinburgh — Western General Hospital
Manchester — Salford Royal, Manchester University NHS Foundation Trust
Leeds — Leeds Teaching Hospitals
Exeter — Royal Devon and Exeter Hospital
Liverpool — Royal Liverpool University Hospital
How to Find Your Match
Our Smart Matcher can help you find Crohn's disease trials tailored to your disease location, complications, treatment history, and biomarker results.
Find Crohn's Disease Trials For You
Our Smart Matcher uses your disease type, treatment history, and biomarkers to find the most relevant clinical trials.