Recent advances and emerging therapies in the non-surgical management of ulcerative colitis

F1000Res. 2018 Aug 7;7:F1000 Faculty Rev-1207. doi: 10.12688/f1000research.15159.1. eCollection 2018.

Abstract

The so-called "biologicals" (monoclonal antibodies to various inflammatory targets like tumor necrosis factor or integrins) have revolutionized the treatment of inflammatory bowel diseases. In ulcerative colitis, they have an established role in inducing remission in steroid-refractory disease and, thereafter, maintaining remission with or without azathioprine. Nevertheless, their limitations are also obvious: lack of primary response or loss of response during maintenance as well as various, in part severe, side effects. The latter are less frequent in anti-integrin treatment, but efficacy, especially during induction, is delayed. New antibodies as well as small molecules have also demonstrated clinical efficacy and are soon to be licensed for ulcerative colitis. None of these novel drugs seems to be much more effective overall than the competition, but they provide new options in otherwise refractory patients. This increasing complexity requires new algorithms, but it is still premature to outline each drug's role in future treatment paradigms.

Keywords: biologicals; small molecules; therapy; ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / metabolism
  • Colitis, Ulcerative / therapy*
  • Humans
  • Molecular Targeted Therapy

Grant support

The author(s) declared that no grants were involved in supporting this work.