Landscape of new drugs and targets in inflammatory bowel disease

Vieujean, Sophie; D’Amico, Ferdinando; Netter, Patrick; Danese, Silvio; Peyrin–Biroulet, Laurent

doi:10.1002/ueg2.12305

Cited by 18 publications

(9 citation statements)

References 144 publications

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“…In recent years, our better understanding of the pathophysiological mechanisms underlying IBD has contributed to expand the therapeutic armamentarium. 103 Current therapies include 5-aminosalicylic acids (5-ASA), corticosteroids, immunomodulators (such as azathioprine, 6-mercaptopurine, methotrexate and cyclosporine), anti-tumour necrosis factor (TNF) agents (including infliximab, adalimumab, certolizumab pegol for CD, golimumab for UC), an anti-integrin α 4 β 7 inhibiting lymphocytes trafficking from the blood into the gut (vedolizumab), an anti-interleukin (IL)–12/23 p40-subunit (ustekinumab) and small molecule Janus kinase (JAK) inhibitors (such as tofacitinib and recently filgotinib in UC). Identifying, prior to treatment initiation, which patients are likely to respond to a specific drug (or even the optimal therapeutic sequence or combination) would improve the disease management and clinical outcomes.…”

Section: Choosing the Appropriate Treatmentmentioning

confidence: 99%

“…Finally, a series of anti-IL23 drugs will probably reach the market in the near future. 103 For these therapies, baseline serum concentration of IL-22 (an upstream regulator of IL-23) could be used to predict response to treatment at week 8. Indeed, patients with an IL-22 concentration greater than or equal to 15.6 pg/mL were more likely to respond to anti-IL23p19.…”

Section: Choosing the Appropriate Treatmentmentioning

confidence: 99%

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Precision medicine and drug optimization in adult inflammatory bowel disease patients

Vieujean

Louis

2023

Therap Adv Gastroenterol

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Inflammatory bowel diseases (IBD) encompass two main entities including ulcerative colitis and Crohn’s disease. Although having a common global pathophysiological mechanism, IBD patients are characterized by a significant interindividual heterogeneity and may differ by their disease type, disease locations, disease behaviours, disease manifestations, disease course as well as treatment needs. Indeed, although the therapeutic armamentarium for these diseases has expanded rapidly in recent years, a proportion of patients remains with a suboptimal response to medical treatment due to primary non-response, secondary loss of response or intolerance to currently available drugs. Identifying, prior to treatment initiation, which patients are likely to respond to a specific drug would improve the disease management, avoid unnecessary side effects and reduce the healthcare expenses. Precision medicine classifies individuals into subpopulations according to clinical and molecular characteristics with the objective to tailor preventative and therapeutic interventions to the characteristics of each patient. Interventions would thus be performed only on those who will benefit, sparing side effects and expense for those who will not. This review aims to summarize clinical factors, biomarkers (genetic, transcriptomic, proteomic, metabolic, radiomic or from the microbiota) and tools that could predict disease progression to guide towards a step-up or top-down strategy. Predictive factors of response or non-response to treatment will then be reviewed, followed by a discussion about the optimal dose of drug required for patients. The time at which these treatments should be administered (or rather can be stopped in case of a deep remission or in the aftermath of a surgery) will also be addressed. IBD remain biologically complex, with multifactorial etiopathology, clinical heterogeneity as well as temporal and therapeutic variabilities, which makes precision medicine especially challenging in this area. Although applied for many years in oncology, it remains an unmet medical need in IBD.

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Section: Choosing the Appropriate Treatmentmentioning

confidence: 99%

Section: Choosing the Appropriate Treatmentmentioning

confidence: 99%

Precision medicine and drug optimization in adult inflammatory bowel disease patients

Vieujean

Louis

2023

Therap Adv Gastroenterol

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“…To provide a landscape of new drugs in IBD, Vieujean et al. conducted an exhaustive search using http://ClinicalTrials.gov 17 . The authors summarized and discussed the molecules which are currently being evaluated in phase 3 clinical trials and briefly described drugs under evaluation in phase 1 and 2 clinical trials.…”

Section: Sequencing Therapy and Landscape Of New Treatment Targetsmentioning

confidence: 99%

Changing paradigms in management of inflammatory bowel disease

Mao

Magro

2022

UEG Journal

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In the last decade, the prevalence of inflammatory bowel disease (IBD) has increased, both in developed and developing regions, with a marked global burden associated with disease management. 1 Our knowledge of IBD pathogenesis, diagnosis, monitoring, and treatment strategy has changed substantially over the last years. To collect the latest evidence and make it available to healthcare professionals, we, hereby, present an IBD special issue focused on the most recent monitoring and treatment innovations.

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“…However, their use is complicated by the abundance of serious adverse events, suboptimal response rates and loss of response[ 18 ]. Modern biologics and small molecules, such as anti-interleukins, anti-integrins, sphingosine-1-phosphate modulators, and Janus kinase inhibitors (JAKis), provide a cost-effective means of targeting natural disease history[ 19 ]. No significant difference in overall safety outcomes was observed between UC patients receiving JAKis and patients receiving other active treatments[ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Disease clearance in ulcerative colitis: A new therapeutic target for the future

Hassan,

Kapur,

Sheikh

et al. 2024

World J Gastroenterol

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Advancements in murine modeling systems for ulcerative colitis have diversified our understanding of the pathophysiological factors involved in disease onset and progression. This has fueled the identification of molecular targets, resulting in a rapidly expanding therapeutic armamentarium. Subsequently, management strategies have evolved from symptomatic resolution to well-defined objective endpoints, including clinical remission, endoscopic remission and mucosal healing. While the incorporation of these assessment modalities has permitted targeted intervention in the context of a natural disease history and the prevention of complications, studies have consistently depicted discrepancies associated with ascertaining disease status through clinical and endoscopic measures. Current recommendations lack consideration of histological healing. The simultaneous achievement of clinical, endoscopic, and histologic remission has not been fully investigated. This has laid the groundwork for a novel therapeutic outcome termed disease clearance (DC). This article summarizes the concept of DC and its current evidence.

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Landscape of new drugs and targets in inflammatory bowel disease

Cited by 18 publications

References 144 publications

Precision medicine and drug optimization in adult inflammatory bowel disease patients

Precision medicine and drug optimization in adult inflammatory bowel disease patients

Changing paradigms in management of inflammatory bowel disease

Disease clearance in ulcerative colitis: A new therapeutic target for the future

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