There is a great unmet clinical need for efficacious, tolerable, economical and orally administrated drugs for the treatment of inflammatory bowel disease (IBD).
New therapeutic avenues have become possible including the development of medications that target specific genetic pathways found to be relevant in other immune mediated diseases.
Dr White and colleagues provided an overview of recent clinical trials for new generation oral targeted medications that may have a future role in IBD management.
Pubmed and Medline searches were performed up to 2018 using keywords: “IBD”, “UC”, “CD”, “inflammatory bowel disease” “ulcerative colitis”, “Crohn's disease” in combination with “phase”, “study”, “trial” and “oral”.
|Multiple therapeutic options are at the disposal of physicians to treat IBD on an individualized basis|
|Alimentary Pharmacology & Therapeutics|
A manual search of the clinical trial register, article reference lists, abstracts from meetings of Digestive Disease Week, United European Gastroenterology Week and ECCO congress were also conducted.
The team observed that in randomized controlled trials primary efficacy endpoints were met for tofacitinib, upadacitinib, and AJM300 in ulcerative colitis.
The researchers found that ozanimod also demonstrated clinical remission.
For Crohn's disease, filgotinib met primary endpoints and laquinimod was also efficacious.
Trials using mongersen and vidofludimus have been halted.
Dr White's team concludes, "This is potentially the start of an exciting new era in which multiple therapeutic options are at the disposal of physicians to treat IBD on an individualized basis."
"Head-to-head studies with existing treatments and longer term safety data are needed for this to be possible."