title: Will novel oral formulations change the management of inflammatory bowel disease?
abstract: BACKGROUND
  The traditional management of inflammatory bowel disease (IBD) with sulphasalazine/5-aminosalicylic acid, glucocorticoids and immunomodulators (i.e., thiopurines and methotrexate) was nearly two decades ago extended with intravenously or subcutaneously administered biologics (i.e., tumor necrosis factor inhibitors and later gut-selective integrin antagonists). However, recently, orally administered treatments with simple, well-characterized, and stable structures consisting of either small molecules or anti-sense therapy have been devised.
  
  
  METHODS
  This review discusses the current approaches with promising new oral drugs with distinct modes of action, including: the Janus kinase inhibitors (i.e., tofacitinib, filgotinib and peficitinib); the immunomodulatory drug (laquinimod); a small α4 antagonist (AJM300); agonists for sphingosine-phosphate receptors (i.e., ozanimod, APD334, and amiselimod), as well as anti-sense therapy (mongersen) targeting SMAD7, drugs which directly target intracellular pathways of relevance for intestinal inflammation.
  
  
  CONCLUSIONS
  A new avenue using easily administered oral therapies for the management of IBD is being introduced. While their place in the clinical armamentarium remains to be proven, it is likely that many of these drugs will find their place in the treatment algorithm of IBD in the next few years. Thus, we will face times in which IBD therapy will be based on significantly more tablets than prescribed today.
authors.affiliation: a Department of Gastroenterology, Medical Section, Herlev Hospital , University of Copenhagen , Herlev , Denmark.
authors.forename: Ole Haagen
authors.initials: OH
authors.lastname: Nielsen
authors.affiliation: a Department of Gastroenterology, Medical Section, Herlev Hospital , University of Copenhagen , Herlev , Denmark.
authors.forename: Jakob Benedict
authors.initials: JB
authors.lastname: Seidelin
authors.affiliation: a Department of Gastroenterology, Medical Section, Herlev Hospital , University of Copenhagen , Herlev , Denmark.
authors.forename: Mark
authors.initials: M
authors.lastname: Ainsworth
authors.affiliation: a Department of Gastroenterology, Medical Section, Herlev Hospital , University of Copenhagen , Herlev , Denmark.|b The Bioinformatics Centre, Biotech Research and Innovation Centre (BRIC) , University of Copenhagen , Herlev , Denmark.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Coskun
mesh_terms: D000284:Administration, Oral; D000818:Animals; D015195:Drug Design; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000503:physiopathology; D058990:Molecular Targeted Therapy; D016376:Oligonucleotides, Antisense / Q000008:administration & dosage
chemical_list: D007155:Immunologic Factors; D016376:Oligonucleotides, Antisense
keywords: Anti-sense therapy; Crohn’s disease; inflammatory bowel disease; oral therapy; small molecules; ulcerative colitis