offered research - Guselkumab instead of Infliximab for fistulising Crohns

Seeking any input from anyone with experience with Guselkumab and whether or not i should consider this research study, over current treatment with infliximab.

I was diagnosed about a year ago with Crohn’s, a change from Ulcerative Colitis diagnosis in 2021. At the time I had an abcess that is now a high transphincter fistula after having a seton placed. At the time I was having mucus, bloody stool up to 20-30 times a day.

After CD diagnosis they started me on infliximab. After about 8-12 weeks I was in remission with one normal poo a day. Nothing short of a mericle really.

However while those symptoms have been under control I’m left with a pretty difficult to treat fistula. Setons in and out, multiple surgeries.

Yesterday my gastro doctor offered inclusion in the FUZION study involving a switch to a Guselkumab and stopping Infliximab. He mentioned that there has been some success in fistula healing.

One downside is that 20% participants get placebo for the first 24 weeks which continues if there is a response. Bit risky. One upside is I get fancy MRI and health screening at the start.

• is it a good idea to switch when I’m having success with infliximab?
• does anyone have any information about comparing the efficacy and side effects of these two biologics?

Any anecdotal experience or knowledge of these drugs deeply thankful for your input.

Cheers.

UPDATE 30/1/2025: So everyones different, but i can share my outcome.

Decided to stick with infliximabe because it was working and not do the trial of the other drug.

My GI team were totally fine and decided to tackle the fistula by increasing my infliximabe from one subcutaneous injection every two weeks, to every week. My fistula is healing. External wound closed after two months, but i can tell that even though a long time has past I'm still at risk of absess and fistula giving me issues.

But I'm so happy.

I thought I'd never be symptom free again. The only minor inconveniance is that i sometimes like to clean the internal area after going to the toilet, because I'm so afraid of anything that could make it return.