A pioneering treatment for one of inflammatory bowel disease's most challenging complications is entering clinical trials, offering new hope for patients with complex fistulising perianal Crohn's disease. The innovative therapy, developed at Hudson Institute of Medical Research, utilizes extracellular vesicles (EVs) derived from human amniotic epithelial cells (hAECs) to potentially deliver comparable benefits to stem cell treatments at significantly lower costs.
Novel Therapeutic Approach for Complex Fistulas
Complex fistulising perianal Crohn's disease, characterized by abnormal connections between the bowel and surrounding tissues, has remained largely incurable and poses significant challenges for patients. These fistulas can lead to severe complications including fecal incontinence, recurring infections, and chronic inflammation.
Dr. Charlotte Keung, IBD specialist gastroenterologist at Monash Health and trial lead, explains: "The goal is to increase treatment accessibility for a debilitating condition without other options, by developing a therapy with significant manufacturing cost reductions and improved commercialisation potential."
Trial Design and Objectives
The groundbreaking trial, conducted in collaboration with Monash Health and Monash University, will recruit 15 participants with complex refractory Crohn's perianal fistulas. This marks the first-ever human application of EV therapy for Crohn's disease worldwide and represents Australia's second human EV trial.
The study's primary objective focuses on safety assessment, while secondary endpoints will evaluate the therapy's effectiveness in fistula healing and quality of life improvements. Professor Elizabeth Hartland AM, Hudson Institute's CEO and Director, emphasizes that these outcomes will guide further optimization of the treatment.
Market Impact and Clinical Significance
Current treatment options for fistulising Crohn's disease are limited by high costs, unreliability, and significant side effects. While stem cell therapies show promise, their widespread adoption is hindered by expensive manufacturing processes and complex logistics.
The hAEC-EV therapy addresses these limitations by eliminating the need for complex cold chain logistics and reducing manufacturing costs associated with live cell treatments. This innovation comes at a crucial time, as the global Crohn's disease market is projected to expand from $9.2 billion to $13.4 billion by 2026, with one-third of patients developing fistulas.
Expert Oversight
The trial will be conducted at Monash Health facilities under the supervision of Associate Professor Greg Moore, an internationally recognized clinician-scientist and Director on the board of Crohn's and Colitis Australia. Associate Professor Rebecca Lim, who pioneered the treatment with her team, will continue to provide scientific leadership for this innovative approach.
