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Review
. 2021 Jul;6(7):589-595.
doi: 10.1016/S2468-1253(21)00065-0. Epub 2021 May 19.

Breaking the therapeutic ceiling in drug development in ulcerative colitis

Dahham Alsoud  1 , Bram Verstockt  2 , Claudio Fiocchi  3 , Séverine Vermeire  4
Affiliations
Review

Breaking the therapeutic ceiling in drug development in ulcerative colitis

Dahham Alsoud et al. Lancet Gastroenterol Hepatol. 2021 Jul.

Abstract

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.

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Conflict of interest statement

Declaration of interests BV reports financial support for research from Pfizer; lecture fees from Abbvie, Biogen, Chiesi, Falk, Ferring, Galapagos, Janssen, MSD, Pfizer, R-Biopharm, Takeda, and Truvion; and consultancy fees from Janssen, Guidepont, and Sandoz. SV reports financial support for research from MSD, AbbVie, Takeda, Pfizer, Johnson & Johnson; lecture fees from MSD, AbbVie, Takeda, Ferring, Centocor, Hospira, Pfizer, Johnson & Johnson, and Genentech and Roche; and consultancy fees from MSD, AbbVie, Takeda, Ferring, Centocor, Hospira, Pfizer, Johnson & Johnson, Genentech and Roche, Celgene, Mundipharma, Celltrion, SecondGenome, Prometheus, Shire, Prodigest, Gilead, and Galapagos. CF received speaker fees from UCB, Sandoz, Janssen, and Genentech; consultancy fees from Athos Therapeutics; and grants from US National Institutes of Health (P30 DK097948-06 and T32DK083251-11). DA declares no competing interests.

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