Emerging therapeutic options in inflammatory bowel disease

Abstract

Inflammatory bowel disease (IBD) is a chronic disease that requires chronic treatment throughout the evolution of the disease, with a complex physiopathology that entails great challenges for the development of new and specific treatments for ulcerative colitis and Crohn´s disease. The anti-tumor necrosis factor alpha therapy has impacted the clinical course of IBD in those patients who do not respond to conventional treatment, so there is a need to develop new therapies and markers of treatment response. Various pathways involved in the development of the disease are known and the new therapies have focused on blocking the inflammatory process at the gastrointestinal level by oral, intravenous, subcutaneous, and topical route. All these new therapies can lead to more personalized treatments with higher success rates and fewer relapses. These treatments have not only focused on clinical remission, but also on achieving macroscopic changes at the endoscopic level and microscopic changes by achieving mucosal healing. These treatments are mainly based on modifying signaling pathways, by blocking receptors or ligands, reducing cell migration and maintaining the integrity of the epithelial barrier. Therefore, this review presents the efficacy and safety of the new treatments that are currently under study and the advances that have been made in this area in recent years.

Keywords: Inflammatory bowel disease; Review; Emerging; Treatment; Ulcerative colitis; Crohn´s disease

Core Tip: This review is to present the efficacy and safety of novel treatments for inflammatory bowel disease. The new treatments that may be available in the future are new anti-tumor necrosis factor alpha, anti-integrines, anti-interleukines, modulation of sphingosine-1-phosphate, janus kinase inhibitors, toll like receptor agonist, therapy on the integrity of the epithelial barrier, phosphodiesterase-4 inhibitors and antisense oligonucleotide therapy, currently in clinical studies. Many of them with encouraging results in clinical studies, while others have not been able to maintain significant results in the final phases.