Novel Therapeutics for the Treatment of IBD: Current Status and Future Directions

Sedaño, Rocío; Almradi, Ahmed; Ma, Christopher; Jairath, Vipul; Feagan, Brian G.

doi:10.1007/s11938-020-00299-7

Cited by 3 publications

(4 citation statements)

References 66 publications

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“…Gut-specific anti-integrin therapeutics such as anti-IL-12/IL-23 agents may also be an option for systemic immunosuppression ( 31 ). Recently, biologics targeting alternative pathways and small-molecule drugs have attracted attention as a newer category of therapeutics that neutralize proteins involved in inflammation ( 32 ). Despite these advances, it is still difficult to control the disease for many IBD patients.…”

Section: Ibdmentioning

confidence: 99%

Diet-Induced Host–Microbe Interactions: Personalized Diet Strategies for Improving Inflammatory Bowel Disease

Lee

Kim

Koh

et al. 2022

Current Developments in Nutrition

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Inflammatory bowel disease (IBD) is an idiopathic inflammatory disease. Environmental sanitization, modern lifestyles, advanced medicines, ethnic origins, host genetics and immune systems, mucosal barrier function, and the gut microbiota have been delineated to explain how they cause mucosal inflammation. However, the pathogenesis of IBD and its therapeutic targets remain elusive. Recent studies highlighted the importance of the human gut microbiota in health and disease, suggesting that the pathogenesis of IBD is highly associated with imbalances of the gut microbiota or alterations of epithelial barrier function in the gastrointestinal (GI) tract. Moreover, diet-induced alterations of the gut microbiota in the GI tract modulate immune responses and perturb metabolic homeostasis. This review summarizes recent findings on IBD and its association with diet-induced changes in the gut microbiota, furthermore, discusses how diets can modulate host gut microbes and immune systems, potentiating the impact of personalized diets on therapeutic targets for IBD.

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Section: Ibdmentioning

confidence: 99%

Diet-Induced Host–Microbe Interactions: Personalized Diet Strategies for Improving Inflammatory Bowel Disease

Lee

Kim

Koh

et al. 2022

Current Developments in Nutrition

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“…Vedolizumab is a second generation humanized antiadhesion medication that blocks the interaction between α 4 β 7 -integrin and MadCAM-1. 37 The GEMINI trials I and II were randomized, placebo-controlled studies that compared vedolizumab to placebo in patients with UC and CD, respectively.…”

Section: Vedolizumabmentioning

confidence: 99%

“…Ustekinumab is a monoclonal immunoglobulin G (IgG) antibody that targets the p40 subunit of the inflammatory cytokines interleukin-12 (IL-12) and IL-23. 37 Two identical randomized placebo-controlled trials evaluated the efficacy of ustekinumab in moderate to severe CD patients: UNITI-1 and UNITI-2. Patients who either had a primary or secondary non-response to TNF or had adverse effects were included in the UNITI-1 trial, while patients who either failed or had severe side effects from conventional treatment but were largely anti-TNF therapy naïve were included in the UNITI-2 trial.…”

Section: Ustekinumabmentioning

confidence: 99%

Indeterminate Colitis – Update on Treatment Options

Venkateswaran¹,

Weismiller²,

Clarke³

2021

JIR

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Indeterminate colitis (IC) is described in approximately 5-15% of patients with inflammatory bowel disease (IBD). It usually reflects a difficulty or lack of clarity in distinguishing between ulcerative colitis (UC) and Crohn's disease (CD) on biopsy or colectomy specimens. The diagnostic difficulty may explain the variability in the reported prevalence and incidence of IC. Clinically, most IC patients tend to evolve over time to a definite diagnosis of either UC or CD. IC has also been interchangeably described as inflammatory bowel disease unclassified (IBDU). This review offers an overview of the available limited literature on the conventional medical and surgical treatments for IC. In contrast to the numerous studies on the medical management of UC and CD, there are very few data from dedicated controlled trials on the treatment of IC. The natural evolution of IC more closely mimics UC. Regarding medical options for treatment, most patients diagnosed with IC are treated similarly to UC, and treatment choices are based on disease severity. Others are managed similarly to CD if there are features suggestive of CD, including fissures, skin tags, or rectal sparing. In medically refractory IC, surgical treatment options are limited and include total proctocolectomy (TPC) and ileal pouch-anal anastomosis (IPAA), with its associated risk factors and complications. Post-surgical complications and pouch failure rates were historically thought to be more common in IC patients, but recent meta-analyses reveal similar rates between UC and IC patients. Future therapies in IBD are focused on known mechanisms in the disease pathways of UC and CD. Owing to the lack of IC-specific studies, clinicians have traditionally and historically extrapolated the data to IC patients based on their symptomatology, clinical course, and endoscopic findings.

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“…Increasing knowledge of the role of pro-inflammatory cytokines and immune cell components in the pathogenesis of the disease has led to the approval in recent decades of targeted therapies that have revolutionized IBD management [5]. These therapies, based on biological drugs include anti-TNF [monoclonal antibodies (mAb) targeting TNF; infliximab, adalimumab and golimumab], vedolizumab (mAb against α4β7 integrin), ustekinumab (mAb against the p40 subunit shared by interleukins 12 and 23), and more recently, JAK inhibitors (small molecules inhibiting JAK-STAT signaling pathways; tofacitinib, filgotinib and upadacitinib) [6].…”

Section: Introductionmentioning

confidence: 99%

Trends in Targeted Therapy Usage in Inflammatory Bowel Disease: TRENDY Study of ENEIDA

Gómez-Labrador,

Ricart,

Iborra

et al. 2024

Pharmaceutics

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Markers that allow for the selection of tailored treatments for individual patients with inflammatory bowel diseases (IBD) are yet to be identified. Our aim was to describe trends in real-life treatment usage. For this purpose, patients from the ENEIDA registry who received their first targeted IBD treatment (biologics or tofacitinib) between 2015 and 2021 were included. A subsequent analysis with Machine Learning models was performed. The study included 10,009 patients [71% with Crohn’s disease (CD) and 29% with ulcerative colitis (UC)]. In CD, anti-TNF (predominantly adalimumab) were the main agents in the 1st line of treatment (LoT), although their use declined over time. In UC, anti-TNF (mainly infliximab) use was predominant in 1st LoT, remaining stable over time. Ustekinumab and vedolizumab were the most prescribed drugs in 2nd and 3rd LoT in CD and UC, respectively. Overall, the use of biosimilars increased over time. Machine Learning failed to identify a model capable of predicting treatment patterns. In conclusion, drug positioning is different in CD and UC. Anti-TNF were the most used drugs in IBD 1st LoT, being adalimumab predominant in CD and infliximab in UC. Ustekinumab and vedolizumab have gained importance in CD and UC, respectively. The approval of biosimilars had a significant impact on treatment.

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Novel Therapeutics for the Treatment of IBD: Current Status and Future Directions

Cited by 3 publications

References 66 publications

Diet-Induced Host–Microbe Interactions: Personalized Diet Strategies for Improving Inflammatory Bowel Disease

Diet-Induced Host–Microbe Interactions: Personalized Diet Strategies for Improving Inflammatory Bowel Disease

Indeterminate Colitis – Update on Treatment Options

Trends in Targeted Therapy Usage in Inflammatory Bowel Disease: TRENDY Study of ENEIDA

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