Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
Expert Opin Emerg Drugs. 2023 Mar;28(1):27-42. doi: 10.1080/14728214.2023.2186399. Epub 2023 Mar 7.
Current therapeutic options for patients with ulcerative colitis comprise monoclonal antibodies against tumor necrosis factor (TNF), alpha4/beta7 integrin, and interleukin (IL)12/23 as well as small molecules such as tofacitinib, upadacitinib, ozanimod, and filgotinib. However, many patients fail to respond to these agents or have loss of response over time. Therefore, there is a large unmet clinical need for new therapeutic agents.
Here, we review recent phase 2/3 studies in active ulcerative colitis and discuss preliminary data on the efficacy (clinical, endoscopic, and histologic remission) and safety of novel drugs including Janus kinase (JAK) inhibitors, IL23 blockers, integrin inhibitors, and S1P1R modulators.
We highlight the potential impact of these agents for the future therapeutic landscape of this disease with special emphasis on clinical impact, unmet needs, safety aspects, and advanced combination therapy.
目前，溃疡性结肠炎患者的治疗选择包括针对肿瘤坏死因子（TNF）、α4/β7 整联蛋白和白细胞介素（IL）12/23 的单克隆抗体，以及托法替尼、乌帕替尼、奥扎那替布和菲戈替尼等小分子药物。然而，许多患者对这些药物没有反应，或者随着时间的推移失去了反应。因此，临床上迫切需要新的治疗药物。
在这里，我们回顾了溃疡性结肠炎的近期 2/3 期研究，并讨论了新型药物的疗效（临床、内镜和组织学缓解）和安全性的初步数据，这些药物包括 Janus 激酶（JAK）抑制剂、IL23 阻滞剂、整合素抑制剂和 S1P1R 调节剂。
我们强调了这些药物对该疾病未来治疗前景的潜在影响，特别强调了临床影响、未满足的需求、安全性方面和先进的联合治疗。
