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Next generation of small molecules in inflammatory bowel disease

Olivera, Pablo, Danese, Silvio, Peyrin-Biroulet, Laurent·2017·Gut
DOI 10.1136/gutjnl-2016-312912
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Abstract

Inflammatory bowel disease (IBD) encompasses two major entities: ulcerative colitis (UC) and Crohn's disease (CD).1 Both are chronic, progressive, disabling conditions that require lifelong medical treatment in most cases. IBD has a major impact on the patient's health-related quality of life,2 and the treatment-related costs place a significant burden on healthcare systems.3 Historically, the medical management of IBD has been based on the use of several small-molecule drugs (SMDs), including corticosteroids, immunomodulators (such as azathioprine, 6-mercaptopurine and methotrexate) and aminosalicylates.4 The introduction of biologic anti-tumour necrosis factor-α (TNF-α) agents in the first few years of this century has revolutionised the clinical management of IBD. In parallel, treatment goals have shifted from symptomatic control towards more objective endpoints (such as mucosal healing and deep remission) associated with better long-term outcomes.5 ,6 Over the past 20 years, drug research in the field of IBD has focused on the development of new, large-molecule biologics; hence, several anti-TNF-α monoclonal antibodies (including infliximab,7 ,8 adalimumab,9 ,10 certolizumab pegol,11 ,12 and golimumab)13 and, most recently, antibodies with other targets (such as vedolizumab14 ,15 and ustekinumab)16 have become available in clinical practice. However, monoclonal antibodies have limitations in terms of efficacy, safety and cost. First, the available biologics are only moder…

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  • Small molecule therapeutics may offer advantages over biologics due to their lower immunogenic and cost-effectiveness.

    “In the setting of aging and chronic disease, small molecule therapeutics may offer advantages over biologics due to their lower immunogenic and cost-effectiveness.43,44”

    From TERT activation targets DNA methylation and multiple aging hallmarks (2024) · cites this paper as [44]

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Metadata

Authors
Olivera, P., Danese, S., & Peyrin-Biroulet, L.
Affiliations
  • Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
  • Humanitas University, IBD Center, Milan, Italy
  • INSERM U954 and Department of Gastroenterology, Nancy University Hospital, Université de Lorraine, Vandoeuvre-lès-Nancy, France
Venue
Gut
Publisher
BMJ
Published
2016-11-17
Volume
66
Issue
2
Pages
199-209
ISSN
  • 0017-5749
  • 1468-3288
DOI
10.1136/gutjnl-2016-312912
Cited by
154
References
6
Language
en

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