Advances in the Treatment of Inflammatory Bowel Disease

David T. Rubin, MD


July 29, 2020

Advances in the treatment of inflammatory bowel disease (IBD) offer clinicians more therapeutic options for patients and opportunities to personalize care. The goal of treatment is to downregulate the patient's overactive immune response such that the patient experiences both relief from symptoms and a modified disease course. Factors such as disease location and severity, as well as the presence of other immune conditions, can help determine the best management approach.

As Dr David Rubin, chief of gastroenterology, hepatology, and nutrition at University of Chicago Medicine, explains, the three classes of biologic therapies approved for IBD have been revolutionary for patient care. However, they are limited by clearance issues, the need for dose escalation, and loss of response caused by immunogenicity.

The arrival of novel small molecules for IBD has provided clinicians with options targeting a variety of molecular signaling pathways. Recent approval of the JAK inhibitor tofacitinib for moderate to severe ulcerative colitis, as well as newly emerging selective JAK inhibitors and S1P receptor modulators, signify a paradigm shift in treating IBD. Dr Rubin argues that these agents may be effective for both induction and maintenance, and perhaps in combination with existing therapies as well.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.