What’s coming down the pipeline?
If a UC patient does not improve on 5-ASA or immunosuppressant therapy with azathioprine/6-MP there are other available medical treatments to consider prior to surgery.
Infliximab is an antibody to tumor necrosis factor (TNF). The not so accurately named TNF, is integral to the development of inflammation in the intestine and throughout the body. Infliximab is administered as an intravenous infusion every 8 weeks. It is effective at reducing UC symptoms and the need for surgery. About 50% of patients who have failed to respond to azathioprine will benefit from infliximab compared to 25% who receive placebo. About one-third of the infliximab treated patients will have a remission of symptoms, twice the placebo response. If infliximab is ineffective, poorly tolerated, or unavailable then the patient would need to undergo surgery or enter into a clinical study.
Adalimumab is an antibody, similar to infliximab, which blocks the pro-inflammatory effects of TNF. It is administered as an intramuscular injection like an epinephrine pen every 1 or 2 weeks. Adalimumab has already been effective and approved for use in Crohn’s disease, rheumatoid arthritis, and psoriasis.
Next week I will review a few more drugs currently undergoing clinical trials for UC.