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A.S. Cheifetz, J.D. Feuerstein (eds.), Treatment of Inflammatory
Bowel Disease with Biologics, https://doi.org/10.1007/978-3-319-60276-9_17
Chapter 17
Novel Agents in Inflammatory Bowel Disease
Fernando Velayos
Every new treatment for inflammatory bowel disease (IBD) is, by definition, novel
at some level. That a treatment is new, of course, does not always equate to the
more commonly understood definition of novel: interesting, groundbreaking, or
transformative. For nearly two decades, novel therapies for IBD have primarily
targeted the same cell signaling cytokine, tumor necrosis factor alpha (TNF-α).
TNF is a key cytokine in inflammatory pathways, and dysregulation of TNF pro-
duction has been implicated in both ulcerative colitis (UC) and Crohn’s disease
(CD). This strategy has been and continues to be effective but not wholly effective.
Nearly a third of patients do not respond to this strategy and others flare despite
initial control [ 1 ].
This chapter focuses primarily on novel agents other than anti-TNFs that have
either been recently released or under late-stage investigation and likely to progress
to market. They can be broadly grouped into either (1) inhibitors targeting white
blood cells from migrating to areas of injury and perpetuating their local inflamma-
tory effect or (2) inhibitors of the inflammatory cascade. The agents reviewed in
this chapter, besides new, are interesting in that they elucidate what pathways and
molecules other than TNF are important in IBD and whether the traditional mono-
clonal antibody strategy is the only viable strategy for treating IBD (Table 17.1).
They have the promise of being groundbreaking or transformative either in their
efficacy, mechanism of action, or route of delivery. This list of course is not exhaus-
tive and always changing. The chapter focuses less on early stage compounds as
their progress into advanced stages of clinical development can be quite variable,
dependent on internal data, funding, and other priority factors that may have noth-
ing to do with science.
F. Velayos
Center for Crohn’s and Colitis, University of California, San Francisco, CA 94143, USA
e-mail: [email protected]