Bretto Elisabetta, Ribaldone Davide Giuseppe, Caviglia Gian Paolo, Saracco Giorgio Maria, Bugianesi Elisabetta, Frara Simone
Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Unit of Gastroenterology, Città della Salute e della Scienza di Torino-Molinette Hospital, 10126 Turin, Italy.
Biomedicines. 2023 Aug 11;11(8):2249. doi: 10.3390/biomedicines11082249.
Inflammatory bowel disease (IBD) is a term used to represent a group of chronic, relapsing inflammatory disorders of the gastrointestinal tract. Crohn's disease (CD) and ulcerative colitis (UC) are the two major clinical forms. The global incidence and prevalence of IBD have increased over the last 2-4 decades. Despite the specific etiopathogenesis of IBD still being unknown, it is widely recognized that immunological, genetic, and environmental factors are implicated. A greater understanding of the multiple signaling pathways involved has led to the development of biologic therapies in the last two decades. Although these treatments have dramatically transformed the course of IBD, there is not a definitive cure and available therapies may cause adverse events (AEs), limiting their use, or have an inadequate effect in some patients. In this context, emerging therapies addressing new specific pathogenetic mechanisms have shown promising efficacy and safety data in early clinical trials. The purpose of this review is to highlight the available clinical trial data for these new drugs, such as more preferential JAK inhibitors, anti-IL-23 antibodies, sphingosine-1-phosphate receptor modulators, anti-integrin therapies, and other small molecules that are currently under research. We will emphasize the potential significance of these agents in shaping future treatment options.
炎症性肠病(IBD)是一个用于代表一组胃肠道慢性复发性炎症性疾病的术语。克罗恩病(CD)和溃疡性结肠炎(UC)是两种主要的临床类型。在过去20至40年中,IBD的全球发病率和患病率有所上升。尽管IBD的具体病因仍不清楚,但人们普遍认为免疫、遗传和环境因素与之相关。在过去二十年中,对所涉及的多种信号通路的更深入了解促使了生物疗法的发展。尽管这些治疗方法极大地改变了IBD的病程,但目前尚无根治方法,现有疗法可能会导致不良事件(AE),限制了其使用,或者在某些患者中效果不佳。在此背景下,针对新的特定致病机制的新兴疗法在早期临床试验中已显示出有前景的疗效和安全性数据。本综述的目的是强调这些新药的现有临床试验数据,例如更具优势的JAK抑制剂、抗IL-23抗体、鞘氨醇-1-磷酸受体调节剂、抗整合素疗法以及目前正在研究的其他小分子药物。我们将强调这些药物在塑造未来治疗选择方面的潜在意义。