The role of filgotinib in ulcerative colitis and Crohn's disease

Immunotherapy. 2024 Feb;16(2):59-74. doi: 10.2217/imt-2023-0116. Epub 2023 Nov 27.

Abstract

Filgotinib is an oral small molecule that selectively inhibits JAK1. It is already approved for the treatment of moderately to severely active ulcerative colitis (UC). Ongoing studies are evaluating the efficacy and safety of filgotinib in Crohn's disease (CD). The purpose of this review is to summarize the available data regarding filgotinib in the management of UC and CD. We used Pubmed, Embase and clinicaltrials.gov websites to search all available data and currently ongoing studies regarding the efficacy and safety of filgotinib in inflammatory bowel diseases. Filgotinib is an effective and safe drug for the management of biologic-naive and biologic-experienced patients with moderate-to-severe UC. The same efficacy results have not been achieved in CD.

Keywords: Crohn’s disease; IBD; JAK inhibitor; filgotinib; inflammatory bowel disease; small molecules; ulcerative colitis.

Plain language summary

Filgotinib is an oral medication that inhibits the activity of the JAK1 enzyme. It has received approval from the European Medicines Agency for the treatment of moderate-to-severe ulcerative colitis, a condition characterized by inflammation in the lower part of the digestive tract. Filgotinib has a rapid mechanism of action and is effective at relieving the symptoms of ulcerative colitis and maintaining this improvement. However, its use is recommended with caution in patients who have risk factors such as heart and blood vessel issues, active smoking, a history of cancer, or those who are elderly (over 65 years old), and only when there are no other viable treatment options available. Although filgotinib was also studied for managing moderate-to-severe Crohn’s disease, a chronic inflammatory condition affecting the digestive system, it did not pass phase III clinical trials and will not be available for this indication.

Publication types

  • Review

MeSH terms

  • Biological Products* / therapeutic use
  • Colitis, Ulcerative* / drug therapy
  • Crohn Disease* / drug therapy
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy

Substances

  • GLPG0634
  • Biological Products