Shukla Tushar, Sands Bruce E
Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY, 10029, USA.
Curr Gastroenterol Rep. 2019 Apr 23;21(5):22. doi: 10.1007/s11894-019-0689-2.
The biologic era revolutionized the medical management of inflammatory bowel disease (IBD) and allowed for a paradigm shift away from a therapeutic strategy that traditionally relied on corticosteroids and immunomodulators. IBD treatment has now further evolved to encompass novel non-biologic agents.
An electronic database search, spanning up to September 2018, was conducted using PubMed, Web of Science, Google Scholar, and Scopus. Abstracts were also reviewed from Digestive Diseases Week, European Crohn's and Colitis Organization congress, Canadian Digestive Diseases Week, and United European Gastroenterology Week. The JAK1/3 inhibitor, tofacitinib, was shown to both induce and maintain clinical remission and mucosal healing in ulcerative colitis (UC). Also, the sphingosine-1-phosphate (SIP) S1P1/S1P5 receptor agonist ozanimod showed benefit with clinical remission and mucosal healing in UC. Anti-trafficking non-biologic therapies such as AJM300 and a phosphodiesterase (PDE) PDE4 inhibitor, apremilast, have shown benefit in terms of clinical response, clinical remission, and mucosal healing in UC. Upadacitinib and filgotinib have shown initial favorable outcomes in CD patients, with further ongoing trials. Non-biologic agents comprise a growing number of mechanisms of action with the promise of safe and effective oral therapy for patients with IBD.
生物制剂时代彻底改变了炎症性肠病（IBD）的药物治疗方式，实现了从传统依赖皮质类固醇和免疫调节剂的治疗策略的范式转变。IBD治疗现已进一步发展，涵盖新型非生物制剂。
利用PubMed、科学网、谷歌学术和Scopus进行了截至2018年9月的电子数据库搜索。还查阅了消化疾病周、欧洲克罗恩病和结肠炎组织大会、加拿大消化疾病周以及欧洲胃肠病学联合周的摘要。JAK1/3抑制剂托法替布在溃疡性结肠炎（UC）中显示出诱导和维持临床缓解及黏膜愈合的作用。此外，鞘氨醇-1-磷酸（SIP）S1P1/S1P5受体激动剂奥扎莫德在UC的临床缓解和黏膜愈合方面显示出益处。抗转运非生物疗法如AJM300和磷酸二酯酶（PDE）PDE4抑制剂阿普司特在UC的临床反应、临床缓解和黏膜愈合方面已显示出益处。乌帕替尼和非戈替尼在CD患者中已显示出初步的良好疗效，且进一步试验正在进行中。非生物制剂的作用机制越来越多，有望为IBD患者提供安全有效的口服治疗。
