IBD therapeutics: what is in the pipeline?

Toskas, Alexandros; Akbar, Ayesha

doi:10.1136/flgastro-2022-102130

Cited by 9 publications

(10 citation statements)

References 46 publications

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“…Efficacy of these newer agents varies by indication, although when used as a first agent they remain more effective (at a population level) then in patients with loss of response to another agent. Similar to anti-TNF agents, trial data reflect a clinical response in only up to ~50% of patients, reflecting a significant primary non-response rate for all therapeutic options 35…”

Section: New and Old Drugs New Approachesmentioning

confidence: 99%

“…Facing challenges such as exhaustion of therapeutic options, complex surgery, adolescent health issues (sexual health, smoking, alcohol) and genetic diagnoses requires paediatric–adult joint working, which goes beyond the traditional model of transition. While transition remains important, evidence suggests a lack of knowledge and engagement from patients and clinicians has determinantal impacts on long-term outcomes 35…”

Section: Linking With Adult Servicesmentioning

confidence: 99%

“…Similar to anti-TNF agents, trial data reflect a clinical response in only up to ~50% of patients, reflecting a significant primary non-response rate for all therapeutic options. 35 …”

Section: New and Old Drugs New Approachesmentioning

confidence: 99%

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Inflammatory bowel disease: recent developments

Ashton

Beattie

2023

Arch Dis Child

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Paediatric-onset inflammatory bowel disease (IBD) is a complex and heterogenous condition. Incidence of disease in those aged <18 years has doubled over the last 25 years, with concurrent increased prevalence and no decrease in disease severity. The tools available at diagnosis for investigation have developed over the last 10 years, including use of better utilisation of faecal calprotectin, improved small bowel imaging and video capsule endoscopy. Alongside this, management options have increased and include biological and small molecule therapies targeting alternative pathways (such as interleukin 12/23, integrins and Janus kinase/signal transducers and activators of transcription, JAK-STAT pathways) and better understanding of therapeutic drug monitoring for more established agents, such as infliximab. Dietary manipulation remains an interesting but contentious topic.This review summarises some of the recent developments in the diagnosis, investigation and management of IBD in children and young people. IBD is increasingly recognised as a continuum of disease, with only some patients presenting with Crohn’s disease or ulcerative colitis phenotypes. Future implementation of personalisation and stratification strategies, including clinical and molecular biomarkers, implementation of predictors of response and outcome and use of additional therapies, will continue to require working within clinical networks and multiprofessional teams.

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Section: New and Old Drugs New Approachesmentioning

confidence: 99%

Section: Linking With Adult Servicesmentioning

confidence: 99%

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Inflammatory bowel disease: recent developments

Ashton

Beattie

2023

Arch Dis Child

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“…Etrolizumab ist ein zweiter darmselektiver monoklonaler Antikörper und richtet sich selektiv auf die β7-Untereinheit der α4β7-und α4E7-Integrine [29]. Die DatenfürEtrolizumabinderBehandlung der CU sind aktuell nicht konsistent.…”

Section: Anti-integrineunclassified

Mise à jour sur le traitement médicamenteux de la colite ulcéreuse

Hadad

Schreiner

Greuter

2023

Schweiz. Gastroenterol.

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ZusammenfassungDas Armamentarium an Therapeutika zur Behandlung der Colitis ulcerosa (CU) wird laufend erweitert. Die Biologika-Klasse dürfte in Kürze um die selektiven Anti-IL23 anwachsen. Selektive JAK-1-Inhibitoren stehen ebenfalls kurz vor der Zulassung. Zudem ist mit dem S1P-Agonisten Ozanimod seit Herbst 2022 das zweite orale „small molecule“ auf dem Markt. Für die etablierten Biologika sind zahlreiche günstigere Biosimilars verfügbar, und die subkutanen Formen von Infliximab und Vedolizumab werden die intravenöse Therapie über kurz oder lang wohl ganz verdrängen. Der/die klinisch tätige Gastroenterologe/-in, zusammen mit dem/der Patienten/-in, steht vor der schwierigen Herausforderung, wo und wie die neuen Präparate, die einander bislang in der Indikationsstellung nicht überlegen sind, im Therapiealgorithmus zu positionieren sind. Publizierte und laufende Head-to-head-Vergleiche werden in diesem Entscheidungsprozess helfen. Nutzen und Nebenwirkungen einer Therapie sowie patientenspezifische Präferenzen (Applikationsform) sind gegeneinander abzuwägen, dies insbesondere, solange noch keine spezifischen Tests vorliegen, welche das Therapieansprechen voraussagen. Schliesslich könnten Kombinationsformen verschiedener Biologika in Zukunft zu höheren Ansprechraten führen (wie die Kombinationstherapie des Anti-TNF Golimumab und des selektiven Anti-IL23 Guselkumab in der Phase-2a-VEGA-Studie), wobei dies in laufenden und geplanten Studien zu zeigen ist.

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“…Inflammatory bowel diseases (IBD) − comprising two main entities, namely ulcerative colitis and Crohn's disease − are a global burden to patients and healthcare systems with a steadily rising incidence affecting at least 0.5% of the population. [ 1 ] While novel drugs are continuously developed, [ 2 ] imaging biomarkers for the evaluation of mucosal healing – the ultimate goal in the treatment of IBD patients – are still controversially discussed. [ 3 ] Until then, white light endoscopy followed by histopathology remains the reference standard to assess disease remission.…”

Section: Introductionmentioning

confidence: 99%

Transrectal Absorber Guide Raster‐Scanning Optoacoustic Mesoscopy for Label‐Free In Vivo Assessment of Colitis

et al. 2023

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Optoacoustic imaging (OAI) enables microscale imaging of endogenous chromophores such as hemoglobin at significantly higher penetration depths compared to other optical imaging technologies. Raster‐scanning optoacoustic mesoscopy (RSOM) has recently been shown to identify superficial microvascular changes associated with human skin pathologies. In animal models, the imaging depth afforded by RSOM can enable entirely new capabilities for noninvasive imaging of vascular structures in the gastrointestinal tract, but exact localization of intra‐abdominal organs is still elusive. Herein the development and application of a novel transrectal absorber guide for RSOM (TAG‐RSOM) is presented to enable accurate transabdominal localization and assessment of colonic vascular networks in vivo. The potential of TAG‐RSOM is demonstrated through application during mild and severe acute colitis in mice. TAG‐RSOM enables visualization of transmural vascular networks, with changes in colon wall thickness, blood volume, and OAI signal intensities corresponding to colitis‐associated inflammatory changes. These findings suggest TAG‐RSOM can provide a novel monitoring tool in preclinical IBD models, refining animal procedures and underlines the capabilities of such technologies to address inflammatory bowel diseases in humans.

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IBD therapeutics: what is in the pipeline?

Cited by 9 publications

References 46 publications

Inflammatory bowel disease: recent developments

Inflammatory bowel disease: recent developments

Mise à jour sur le traitement médicamenteux de la colite ulcéreuse

Transrectal Absorber Guide Raster‐Scanning Optoacoustic Mesoscopy for Label‐Free In Vivo Assessment of Colitis

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