Small Molecules as Advanced Therapy for the Treatment of Inflammatory Bowel Disease, Particularly Regarding Ulcerative Colitis - PubMed
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- #Small Molecules
- #Ulcerative Colitis
- #Inflammatory Bowel Disease
- Small molecules for IBD treatment are orally administered, act quickly, and avoid immunogenicity.
- Three JAK inhibitors (tofacitinib, filgotinib, upadacitinib) are used in Japan, each with distinct efficacy and safety profiles.
- Two S1PR modulators (ozanimod, etrasimod) and one alpha4-integrin antagonist (carotegrast methyl) are also available.
- Upadacitinib shows high efficacy but more adverse events, while filgotinib is less effective but safer.
- Safety risks like cardiovascular events from tofacitinib in rheumatoid arthritis haven't been seen in ulcerative colitis.
- S1PR modulators differ in titration and lymphocyte recovery post-discontinuation.
- Overall, small molecules are effective and convenient, but safety requires individual patient assessment.