Switching IBD medications to reduce hidden bowel inflammation

This trial is testing a strategy for people with inflammatory bowel disease (IBD) — specifically ulcerative colitis or Crohn's disease — who feel fine but still have moderate to severe inflammation visible during endoscopy or imaging. Half of participants will be switched to a different targeted immunomodulator medication (such as biologic agents or small molecule inhibitors), while the other half will continue their current medication. The study will follow people for 2 years to see which approach better prevents future flares and complications.

Many people with IBD feel well and have no symptoms, but doctors can see inflammation in the bowel during endoscopy. It's unclear whether switching to a different medication to completely heal the bowel lining prevents future problems better than staying on the current treatment.