Emerging Therapies for Ulcerative Colitis: Updates from Recent Clinical Trials

Abstract

Ulcerative colitis (UC) is a chronic and progressive inflammatory disorder that affects the colon. The advent of advanced therapies such as biologic agents and small molecules has revolutionized the management of UC. Despite the expanding therapeutic armamentarium of advanced therapies to treat UC, the overall net remission rates and durability of currently available agents are relatively low. This highlights the need for further drug development and more innovative clinical trial design. There are currently multiple emerging agents in the pipeline for the management of UC. This includes agents with alternative routes of administration such as oral or subcutaneous tumor necrosis factor inhibitors or novel mechanisms of action such as toll-like receptor 9 (TLR9) agonist cobitolimod and phosphodiesterase 4 inhibitor apremilast. In this review, we will highlight novel and emerging advanced therapies currently in the pipeline for the management of UC.

Keywords:

• inflammatory bowel disease
• ulcerative colitis
• small molecules
• biologics
• novel therapy

Abbreviations

cAMP, cyclic adenosine monophosphate: CD, Crohn’s disease; CRP, C-reactive protein; EMA, European Medicine Agency; IBD, inflammatory bowel disease; Ig, immunoglobulin; IL, interleukin; IFN, interferon; IV, intravenous; JAK, janus kinase; NF-κB, nuclear transcription factor kappaB; S1P, sphingosine 1-phosphate; SC, subcutaneous; TNFi, tumor necrosis factor inhibitor; TYK, tyrosine kinase; UC, ulcerative colitis.

Disclosure

Dr. Turki AlAmeel: Speaker fees: AbbVie, Takeda, Bristol-Myers Squibb, Janssen Pharmaceuticals, Hikma, Amgen. Advisory board: AbbVie, Takeda, Bristol-Myers Squibb, Janssen Pharmaceuticals, Hikma. Dr. Abdulelah AlMutairdi: Speaker fees: AbbVie, Takeda, Bristol-Myers Squibb. Advisory board: AbbVie, Takeda, Bristol-Myers Squibb, Pfizer. Dr. Badr Al-Bawardy: Speaker fees: AbbVie, Takeda, Bristol-Myers Squibb, Janssen Pharmaceuticals. Advisory board: Bristol-Myers Squibb, Pfizer. The authors report no other conflicts of interest in this work.