Up to 10 million people worldwide live with inflammatory bowel disease (IBD), which refers to two chronic conditions that cause inflammation in the digestive tract: ulcerative colitis (UC) and Crohn’s disease. Both diseases cause the immune system to attack the digestive lining, resulting in chronic inflammation that can lead to lasting damage in the gut if left untreated.
Getting a diagnosis of IBD can be challenging. Symptoms such as diarrhea, abdominal cramping, bloody stools, fatigue and bowel urgency can be mistaken for having other causes. Because no single test can diagnose the condition, patients typically undergo a battery of tests, including endoscopy, scans, blood tests and tests that look for blood in stool. Besides confirming an IBD diagnosis, these tests help physicians pinpoint the type of IBD a patient has.
Despite the difficulty in receiving a diagnosis and the complexity of the disease, people living with IBD have reason to feel hopeful. Johnson & Johnson has long been committed to developing treatments for IBD, including therapies that can suppress the immune system, reduce inflammation and decrease the severity of flare-ups. In the 1990s, the company pioneered the first biologic treatment to manage IBD symptoms. Since then, Johnson & Johnson has continued researching and developing therapies that improve patients’ health.
“We have more treatments available now,” says Esi Lamousé, M.D., Ph.D., Vice President, Gastroenterology Disease Area Lead, Immunology, Johnson & Johnson, “and more are in the pipeline across the industry.”
Part of the challenge is that IBD, like all immune-mediated conditions, is a multipathway disease. “Many things combine to trigger and drive inflammation in the gut,” says Dr. Lamousé. While genes may play a part, so does a person’s gut microbiome and environmental factors, such as the foods they eat and their exposure to pollutants.
“We still have a way to go to get closer to truly curing IBD,” says Dr. Lamousé. “But the spectacular pace of drug development and deeper knowledge of the disease promise that we’ll continue to build on the IBD therapies we’ve already developed.”
That promise wouldn’t be possible without the doctors who first identified IBD more than a century ago, as well as the researchers who laid the groundwork for a clearer understanding of the disease and how to approach treatment. Here’s a look at 11 important milestones, plus what the company currently has in development.
Getting a diagnosis of IBD can be challenging. Symptoms such as diarrhea, abdominal cramping, bloody stools, fatigue and bowel urgency can be mistaken for having other causes. Because no single test can diagnose the condition, patients typically undergo a battery of tests, including endoscopy, scans, blood tests and tests that look for blood in stool. Besides confirming an IBD diagnosis, these tests help physicians pinpoint the type of IBD a patient has.
Despite the difficulty in receiving a diagnosis and the complexity of the disease, people living with IBD have reason to feel hopeful. Johnson & Johnson has long been committed to developing treatments for IBD, including therapies that can suppress the immune system, reduce inflammation and decrease the severity of flare-ups. In the 1990s, the company pioneered the first biologic treatment to manage IBD symptoms. Since then, Johnson & Johnson has continued researching and developing therapies that improve patients’ health.
“We have more treatments available now,” says Esi Lamousé, M.D., Ph.D., Vice President, Gastroenterology Disease Area Lead, Immunology, Johnson & Johnson, “and more are in the pipeline across the industry.”
Part of the challenge is that IBD, like all immune-mediated conditions, is a multipathway disease. “Many things combine to trigger and drive inflammation in the gut,” says Dr. Lamousé. While genes may play a part, so does a person’s gut microbiome and environmental factors, such as the foods they eat and their exposure to pollutants.
“We still have a way to go to get closer to truly curing IBD,” says Dr. Lamousé. “But the spectacular pace of drug development and deeper knowledge of the disease promise that we’ll continue to build on the IBD therapies we’ve already developed.”
That promise wouldn’t be possible without the doctors who first identified IBD more than a century ago, as well as the researchers who laid the groundwork for a clearer understanding of the disease and how to approach treatment. Here’s a look at 11 important milestones, plus what the company currently has in development.
- 1793
A pioneering doctor published the first description of IBD
Scottish physician Matthew Baillie published a medical book, Morbid Anatomy of Some of the Most Important Parts of the Human Body, that contains the first report of a mysterious bowel disease consistent with a diagnosis of IBD. - 1859-1875
Ulcerative colitis was named
The term “ulcerative colitis” (UC) was coined by English doctor Samuel Wilks after he encountered a patient with a unique noninfectious gastrointestinal condition.
Another 16 years passed before UC was accepted as a distinct disease, though the medical establishment is unsure of its cause. Some physicians attributed it to intestinal tuberculosis. Others believed it to psychosomatic. - 1902
Early UC treatment included “irrigating” the colon with disinfectant
Though doctors had seen more cases of UC, an understanding of the disease and its treatment was in its infancy. In 1902, physicians attempted to relieve symptoms with a surgical procedure that allowed for the “irrigation” of the colon with potassium permanganate, a chemical compound that can be used as a disinfectant. 
Crohn’s disease can impact any part of the digestive tract, including the stomach. 1932Crohn’s disease was identified
Working with two other researchers at Mt. Sinai Hospital in New York City, Burrill Crohn, M.D., published a medical paper describing a new disease entity—which later was named after him.
UC and Crohn’s disease were now considered two separate conditions to be known collectively as IBD. While a cause was still in question, Dr. Crohn and his colleagues debunk the intestinal tuberculosis theory.- 1938
Doctors had an effective medication
Controlled trials showed that a medication already in use to treat rheumatoid arthritis—like IBD, also an immune-mediated condition—brought about remission in 50 to 75% of patients with active UC. Patients given the drug were found to be five times less likely than untreated patients to relapse.
At first, doctors didn’t understand why this medication was helpful. Over time, they realized that one of its main ingredients reduces inflammation in the mucus lining of the gut, advancing the idea that IBD was an autoimmune disorder. The medication became a standard way to relieve mild to moderate UC, though it was not as effective at healing the deep layers of inflammation caused by Crohn’s disease. 
Steroids were administered through an IV as a treatment for IBD. 1950sSteroids were introduced as an IBD therapy
With the only approved treatment not effective for everyone with IBD, “doctors ended up relying a lot on steroids, an anti-inflammatory medication, to try to quiet the disease and get people into remission,” says Dr. Lamousé. “Administering steroids via an IV helped control flareups, but side effects of steroids became a risk.” When taken long-term, corticosteroids can lead to conditions like high blood pressure, diabetes, glaucoma and osteoporosis.- 1990s
Medications that “switch off” the immune system were discovered
An organ transplant medication, followed by long-term use of another powerful immune system suppressant, became a new way to treat UC. These drugs worked by blocking cytokines, a group of proteins that power the immune system. By blocking cytokines, the immune system is switched off, preventing inflammation.
Researchers also hit upon an important discovery. In people with IBD, cytokines often use two different pathways, known as TNF (tumor necrosis factor) and IL-23 (interleukin-23), to activate the immune system. Would people with IBD get relief if one or both pathways could be shut down? IBD drug development suddenly has a promising new direction to go in. - 1998-1999
A Johnson & Johnson biologic changed the paradigm
A Johnson & Johnson biologic became the first anti-TNF antibody approved by the U.S. Food and Drug Administration (FDA) to treat Crohn’s disease in the U.S. It’s approved for use against Crohn’s in the EU one year later. Initially used for rheumatoid arthritis, this therapy becomes a game changer in managing Crohn’s disease and eventually UC.
“When an IBD patient responds to a treatment, we’re looking for resolution of symptoms like blood in their stool, abdominal pain and fatigue,” says Dr. Lamousé. “We also look through the camera during a colonoscopy to see that the surface of their intestine looks normal and to take a biopsy of the tissue so we can confirm that their gut lining no longer has inflammatory cells. This is how we define remission, and when anti-TNF antibody was introduced, we achieved remission at rates that you couldn’t achieve before.
“Still, people with IBD don’t maintain remission with a single agent like a TNF,” notes Dr. Lamousé. “Over time, they stop responding to it.” Company researchers continued looking for longer-lasting solutions. 
Illustration of colonic epithelial cells, which line the inner surface of the colon and impact digestive health and immune function. 2016The company launched an anti-inflammatory drug
Johnson & Johnson developed another therapy that relieves IBD by stopping inflammation in the gut. Instead of focusing on the TNF pathway, it focuses on IL-23 as well as IL-12, another protein that is involved in inflammatory and immune responses.
“This advancement for IBD was truly exciting,” says Dr. Lamousé. “Finally, people who start to lose response to TNF have another option.”- 2022
Clinical trials for Johnson & Johnson’s novel combination therapy showed promise
Johnson & Johnson researchers began investigating combination therapy, the use of two different medications at once, to improve IBD outcomes. Patients with moderate to severe UC were treated with a rheumatoid arthritis treatment, which works on the TNF pathway, as well as an IL-23 medication. - 2024
Johnson & Johnson’s latest therapy gained FDA approval for moderate to severe UC
Johnson & Johnson launched a newly FDA-approved treatment for moderately to severely active UC, known as a dual-acting monoclonal antibody. A clinical trial found that people treated with this latest therapy showed significant improvement in their symptoms. A significant proportion of patients also had evidence of healing in their intestines as determined by colonoscopy and histology. 
The quest to find even more effective IBD treatments is ongoing. 2025Johnson & Johnson continues to pursue innovative treatment approaches
Company researchers are looking into even more groundbreaking treatment approaches. One involves the field of mucosal immunology, which focuses on immune system responses that take place in the mucosal lining of the intestines. The hope is that this specialized immunology may hold the key to even more effective IBD therapies.
Researchers are also delving deeper into combination therapy, says Dr. Lamousé. “Can you combine two different pathways together in one single drug? And are there creative ways to develop the combinations? An exciting treatment possibility involves multispecific antibodies, which are engineered to bind to more than one protein at a time.
“We’re trying to raise the efficacy bar even higher for patients who would otherwise not have any other options or would still be suffering, even though they’re on the best therapy available,” says Dr. Lamousé. “We have good tools in our toolbox already, but these combinations are the future.”
