EMERGING OPTIONS FOR THE TREATMENT OF ULCERATIVE COLITIS

A high proportion of patients with ulcerative colitis (UC) do not achieve clinical remission with current therapies, including mesalazine, immunosuppressors and anti-TNF agents. The latest pathophysiological findings have led to a range of new and different target therapies in UC. The purpose of this report is to provide clinicians with an overview of emerging options for the treatment of UC. The scientific literature was reviewed to evaluate data on the use of immunosuppressors, anti-TNF agents, leukocyte trafficking inhibitors, inhibitors of Janus kinase, drugs to protect the mucosal barrier, anti-IP-10 antibodies and Toll-like receptor 9 agonists in UC. The blockade of the alpha 4 beta 7/MAdCAM-1 interaction, particularly vedolizumab, is an effective and safe gut-specific treatment. Tofacitinib, which blocks the JAK/STAT pathway, is showing impressive results, with the highest rate of clinical response and clinical remission. Also, treatment with LT-02, a mucoprotective substance and the first substance interacting with the mucosa, shows good results. Agents targeted against multiple targets in the pathophysiology of UC have shown positive results in phase I-III trials and hold great promise for the future. Overall, more clinical research is needed to optimize the future role of these agents.