Small molecule oral targeted therapies in ulcerative colitis

Lancet Gastroenterol Hepatol. 2020 Sep;5(9):850-861. doi: 10.1016/S2468-1253(19)30414-5. Epub 2020 Mar 11.

Abstract

The incidence and prevalence of ulcerative colitis are increasing globally. Although the exact cause and pathogenesis of this disease is unclear, research has led to a better understanding of the condition and to identification of new targets for therapy, which in turn has encouraged the development of new therapies. As well as biologic therapies, which have changed the way inflammatory bowel disease is managed, small molecules have been developed for the treatment of ulcerative colitis. These small molecule treatments are orally administered and are likely to bring a substantial shift in the way this chronic disease is treated. Oral therapies offer many advantages over infusion therapies, such as ease of use, increased acceptability by patients, and reduction of cost. This Review focuses not only on oral therapies that have been approved for use in ulcerative colitis, but also on those that are in development, providing a comprehensive overview for clinicians of available oral therapies and drugs that are likely to become available. We have also reviewed drugs that have shown promise in preclinical studies and could be effective future therapies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Oral
  • Aged
  • Chronic Disease / drug therapy
  • Clinical Trials as Topic
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / epidemiology
  • Cyclic Nucleotide Phosphodiesterases, Type 4 / drug effects
  • Drug Evaluation, Preclinical / methods
  • Humans
  • Immunomodulation
  • Incidence
  • Inflammatory Bowel Diseases / drug therapy*
  • Janus Kinase Inhibitors / pharmacology
  • Janus Kinases / antagonists & inhibitors
  • Janus Kinases / drug effects
  • Middle Aged
  • Molecular Targeted Therapy / methods*
  • Phosphodiesterase 4 Inhibitors / pharmacology
  • Prevalence
  • Sphingosine-1-Phosphate Receptors / agonists
  • Sphingosine-1-Phosphate Receptors / drug effects

Substances

  • Janus Kinase Inhibitors
  • Phosphodiesterase 4 Inhibitors
  • Sphingosine-1-Phosphate Receptors
  • Janus Kinases
  • Cyclic Nucleotide Phosphodiesterases, Type 4