Breaking the therapeutic ceiling in drug development in ulcerative colitis. (July 2021)

• Record Type: Journal Article
• Authors: Alsoud, Dahham; Verstockt, Bram; Fiocchi, Claudio; Vermeire, Séverine
• Is Part Of: Lancet gastroenterology and hepatology. Volume 6:Number 7(2021)
• Page Start: 589
• Page End: 595
• Publication Date: 2021-07
• DOI: 10.1016/S2468-1253(21)00065-0
• Languages: English
• ISSNs: 2468-1253

Abstract

Summary: Increased knowledge of the intricate pathogenesis of ulcerative colitis has triggered an advance in drug development during the past two decades, resulting in the advent of several biological agents and small-molecule therapies. Although the increase in therapeutic options is positive, remission rates of patients with ulcerative colitis given new therapeutic agents in induction trials remain at a modest 20–30%, seemingly facing a so-called therapeutic ceiling. This therapeutic ceiling requires a critical appraisal and highlights the need for alternative strategies for drug development. In this Review, we objectively itemise the boundaries of therapeutic efficacy in ulcerative colitis, provide possible explanations for the shortcomings of current strategies, and propose solutions to achieve better therapeutic outcomes in ulcerative colitis.