While 2020 was challenging to say the least, we did see positives in the advancement of treatments for patients with ulcerative colitis. This comes as welcome news for many, with about 38,000 people a year diagnosed with UC. From new biologics, topical medicines, and immune modulators, ever growing research is supporting these treatments and more. Come with me as we review these exciting and promising treatments to improve the lives of those with UC in the coming years.
First up, new research supporting Remicade as the most effective biologic for naive biologic UC patients. After 16 different trials, the University of California in San Diego announced, “infliximab best for endoscopic improvement, with a surface under the cumulative ranking curve of 0.95.” This is great news for those with UC seeking care through the use of biologics. Remicade has also been studied quite a bit, as it has been around for over twenty years, and has been found to be effective for long term use.
Next, we have Stanford University School of Medicine in California’s findings of individuals with UC treated by colostomy or pouchoscopy, had lower rates of lithocholic and deoxycholic acid and secondary bile acids (SBAs). They also found fewer of the genes required to convert primary bile acids to SBAs. “This data suggest that dysbiosis induces SBA deficiency in inflammatory-prone UC patients, which promotes a pro-inflammatory state within the intestine that may be treated by SBA restoration.” This could be another benefit to being treated with colectomy for UC patients who have exhausted other options.
Earlier last year a Japanese study found that in fecal microbiota transplantation (FMT) treatment of UC patients, that remission was achieved more often when treated by using a sibling rather than a parent. This evidence leads to the conclusion that the closer in age the donor to the patient, the better the outcome overall. They found that particularly those with less than 10 years age difference improved remission rates long term. While this treatment is not fully accepted by the IBD community, these findings may help it grow in popularity.
While there were other advances, the last one I would like to mention, is a new topical treatment specifically for left-sided UC, that is showing a promising start. Towards to end of last year the phase llb CONDUCT trial found that, “among patients with treatment-refractory, moderate-to-severe left-sided UC, clinical remission at week 6 was higher in those receiving two topical administrations of cobitolimod 250 mg than in placebo recipients.” This is promising news, as it could lead to more control with less medication. This drug, obitolimod, is a DNA based medication that acts as a catalyst to toll-like receptor 9 (TLR9), and was shown to improve mucosal healing by acting as an immunomodulator. The team at the University Hospital Erlangen in Germany had this to say, “TLR9 activation is a promising novel therapeutic target in ulcerative colitis and warrants further testing, with phase 3 trials of cobitolimod planned.”
With all these advances in treatment, I hope it gives you a sense of optimism for what the future could hold, not only for patients with UC but for those with Crohn’s as well. In the words of Franklin D. Roosevelt, “We have always held to the hope, the belief, the conviction that there is a better life, a better world, beyond the horizon.”
Want to check out the full article by MedPage Today? Take a look HERE!
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