Emerging treatments for ulcerative colitis: a systematic review

Scand J Gastroenterol. 2017 Sep;52(9):923-931. doi: 10.1080/00365521.2017.1326163. Epub 2017 May 14.

Abstract

Objectives: Various investigational medicinal products have been developed for ulcerative colitis (UC). Our aim was to systematically evaluate novel pharmacological therapeutic agents for the treatment of UC.

Material and methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were followed. A search of the medical literature was conducted in the MEDLINE database for original research papers published between 01 January 2010 and 31 October 2014.

Results: Twenty one studies, including 11,524 adults were analyzed. Thirteen different novel therapeutic drug options were identified. Vedolizumab and golimumab were superior to placebo as induction and maintenance therapy. Tofacitinib showed dose related efficacy for induction therapy. Etrolizumab showed higher clinical remission rates compared to placebo. Phosphatidylcholine led to an improved clinical activity index. HMPL-004 may become a mesalamine alternative for mild to moderate UC. PF00547,659 was well tolerated. Statins were not beneficial for acute exacerbations of UC. Abatacept, rituximab and visilizumab did not lead to improved outcomes compared to placebo. Higher concentration of BMS 936557 was associated with improved efficacy compared to placebo. Basiliximab did not enhance corticosteroid efficacy.

Conclusions: Patients with UC might achieve clinical response or remission by utilizing some of these agents with a favorable side effect profile. Further studies are needed to evaluate their short- and long-term efficacy and safety.

Keywords: Drug efficacy; drug safety; inflammatory bowel disease; ulcerative colitis.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Andrographis paniculata
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Colitis, Ulcerative / drug therapy*
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Induction Chemotherapy
  • Mesalamine / therapeutic use
  • Piperidines / therapeutic use
  • Plant Extracts / therapeutic use
  • Pyrimidines / therapeutic use
  • Pyrroles / therapeutic use
  • Remission Induction

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • BMS-936557
  • Gastrointestinal Agents
  • Piperidines
  • Plant Extracts
  • Pyrimidines
  • Pyrroles
  • Andrographis paniculata extract
  • Mesalamine
  • tofacitinib
  • golimumab
  • vedolizumab
  • etrolizumab