Novel Therapies for Inflammatory Bowel Disease

Purpose of review Significant advances in the discovery of novel therapeutic targets for inflammatory bowel disease address a crucial need for patients refractory to available treatment options. We will review the recent literature and data available for novel therapies for adult patients with Crohn’s disease (CD) and ulcerative colitis (UC), limited to those currently in phase III trials with a focus on clinical endpoints and safety. Recent findings Emerging therapeutic agents currently in phase III trials including IL-23 inhibitors (risankizumab, guselkumab, and mirikizumab), JAK inhibitors (filgotinib and upadacitinib), and S1P1 modulators (ozanimod and etrasimod) are effective in the treatment of patients with moderate to severe CD and UC. Therapies with greater selectivity, including IL-23 inhibitors, have favorable safety profiles. Small molecules including JAK inhibitors and S1P receptor modulators are both orally administered and non-immunogenic. Emerging novel agents recently approved or currently in phase III trials appear to be effective and safe for the treatment of CD and UC and will expand options for medically refractory patients. Future comparative effectiveness studies and progress in precision medicine may influence therapy selection.