Advances in the biological treatment of IBDs

Abstract

Inflammatory bowel disease, includes Crohn’s disease and ulcerative colitis, is a chronic condition characterized by persistent intestinal inflammation, resulting in significant morbidity and disability. Standard current therapeutic modalities, such as aminosalicylates, corticosteroids, immunomodulators and Anti-TNFα biologics, yet having yielded various therapeutic advantages in disease induction and maintenance of remission, however a significant percentage of patients encounter primary irresponsiveness to the treatment or secondary loss of efficacy. These drawbacks contributed to the development of novel and advanced biological treatments. anti-adhesion molecules such as vedolizumab and etrolizumab target leukocyte migration selectively in the gut with lower systemic immunosuppression. Other biologics like Ustekinumab and Risankizumab have shown effectiveness in reducing inflammatory responses through IL-12 and IL-23 pathway inhibition, with favourable safety profiles. Oral alternatives to biologics are small molecule drugs that include Janus kinase inhibitors (tofacitinib, Upadacitinib and filgotinib) and Sphingosine-1-phosphate receptor modulators (ozanimod, etrasimod)