title: Next-Generation Therapeutics for Inflammatory Bowel Disease.
abstract: Tumor necrosis factor (TNF) antagonists are the cornerstone of therapy for moderately to severely active inflammatory bowel disease (IBD). Although our understanding of pharmacokinetics, pharmacodynamics, and treatment optimization for these agents has evolved considerably over the past decade, a substantial majority of individuals fail to respond or lose response to TNF-antagonists over time. A need therefore remains for efficacious treatment options in these patients. Alternative immunological targets have now been identified, and several novel therapeutic agents are in development for IBD. In this review article, we discuss these novel therapeutic agents, with a particular focus on those demonstrated to be efficacious in phase 2 and 3 clinical trials. We further discuss considerations to be made when integrating these agents into routine practice over the next decade.
authors.affiliation: Division of Gastroenterology, University of California at San Diego, La Jolla, CA, USA.
authors.forename: Parambir S
authors.initials: PS
authors.lastname: Dulai
authors.affiliation: Division of Gastroenterology, University of California at San Diego, La Jolla, CA, USA. wsandborn@ucsd.edu.
authors.forename: William J
authors.initials: WJ
authors.lastname: Sandborn
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001688:Biological Products / Q000627:therapeutic use*; D015815:Cell Adhesion Molecules; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007136:Immunoglobulins; D007189:Indans / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D009088:Mucoproteins / Q000037:antagonists & inhibitors; D009841:Oligonucleotides / Q000627:therapeutic use; D010069:Oxadiazoles / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D000069549:Ustekinumab / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D015815:Cell Adhesion Molecules; D005765:Gastrointestinal Agents; D007136:Immunoglobulins; D007189:Indans; C504265:MADCAM1 protein, human; D009088:Mucoproteins; D009841:Oligonucleotides; D010069:Oxadiazoles; D010880:Piperidines; D011743:Pyrimidines; D011758:Pyrroles; D014409:Tumor Necrosis Factor-alpha; C479163:tofacitinib; C543529:vedolizumab; D000069549:Ustekinumab; C559198:etrolizumab; C000588548:GED0301; C000607776:ozanimod
keywords: Biologics; Etrolizumab; Tofacitinib; Ustekinumab; Vedolizumab