Extracorporeal photopheresis for the treatment of Crohn's disease.

Small, open-label studies show promising results for ECP in the treatment of steroid-dependent and medically-refractory Crohn's disease. However, proper randomized, sham-controlled trials have not yet been performed. Based on the proposed mechanism of action of ECP, induction of a tolerogenic T cell response, ECP should be assessed in patients with early inflammatory disease rather than those who have progressed to fibrotic or stricturing disease. Randomized, sham-controlled trials need to be performed before ECP can be incorporated into standard clinical practice for the treatment of Crohn's disease.