Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jul 23:15:121-128.
doi: 10.2147/CEG.S350193. eCollection 2022.

Critical Appraisal of Filgotinib in the Treatment of Ulcerative Colitis: Current Evidence and Place in Therapy

Arianna Dal Buono  1 , Roberto Gabbiadini  1 , Virginia Solitano  1   2 , Edoardo Vespa  1   2 , Tommaso Lorenzo Parigi  1   2 , Alessandro Repici  2   3 , Antonino Spinelli  1   2   4 , Alessandro Armuzzi  1   2
Affiliations
Review

Critical Appraisal of Filgotinib in the Treatment of Ulcerative Colitis: Current Evidence and Place in Therapy

Arianna Dal Buono et al. Clin Exp Gastroenterol. .

Abstract

Background and aims: Patients affected by moderate-to-severe Ulcerative Colitis (UC) demand a challenging management. Small molecules, administrated as oral agents, have the ambition of overcoming the limitations of the biologic agents (ie, parenteral administration, rapidity of action, primary and secondary non-responsiveness). Beyond tofacitinib, a pan-Janus kinase (JAK) inhibitor already approved for the treatment of moderate-to-severe UC, novel more selective molecules like filgotinib are being currently evaluated in randomized clinical trials. We aimed to review the current evidence on filgotinib, a JAK-1 preferential inhibitor, in the treatment of UC and its place in therapy in the current scenario.

Methods: PubMed and EMBASE were searched to identify relevant studies: those investigating the efficacy and safety of filgotinib in the treatment of UC patients were included in this narrative review.

Results: The current preliminary data have shown that filgotinib is safe and effective in inducing clinical end endoscopic response in both biologic-naïve and biologic-experienced patients with moderate-to-severe UC, also with high inflammatory burden at baseline. In the SELECTION trial, one case of pulmonary embolism occurred with filgotinib 200 mg induction, and three venous thrombosis cases were observed in the placebo maintenance/LTE; the incidence of herpes zoster was ≤1% in all UC treated patients. Filgotinib represents an appealing treatment option for its high selectiveness, route of administration and rapidity of action; cost-effectiveness studies and head-to-head trials are needed to better define its place in therapy.

Keywords: Janus kinase inhibitors; efficacy; filgotinib; safety; ulcerative colitis.

PubMed Disclaimer

Conflict of interest statement

A Armuzzi has received consulting and/or advisory board fees from AbbVie, Allergan, Amgen, Arena, Biogen, Bristol-Myers Squibb, Celltrion, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, MSD, Mylan, Pfizer, Protagonist Therapeutics, Roche, Samsung Bioepis, Sandoz, Takeda, lecture and/or speaker bureau fees from AbbVie, Amgen, Arena, Biogen, Bristol-Myers Squibb, Celltrion, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, MSD, Mitsubishi Tanabe, Novartis, Pfizer, Roche, Samsung Bioepis, Sandoz, Takeda, Tigenix, and research grants from MSD, Pfizer, Takeda and Biogen. A Spinelli has served as a speaker, consultant or advisory board member for Ethicon, Takeda, Pfizer, Sofar, Oasis. A Repici received consultancy fee from Medtronic. A Dal Buono, R Gabbiadini, V Solitano, E Vespa and T Parigi declare no conflict of interests. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
JAK-STAT pathway in the signaling of inflammatory cytokines. JAK proteins are intracellular cytoplasmic tyrosine kinases constitutively associated with intracellular domains of type I and/or type II cytokine receptors; every JAK isoform exhibits binding preferences for different cytokines receptors. Once the extracellular ligand binds the receptor, JAKs activate in pairs via phosphorylation and downstream activate STAT transcription factors. This pathway regulates cellular growth, differentiation, migration, and survival, especially of the T lymphocytes. Created by Biorender.com.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF. Ulcerative colitis. Lancet. 2017;389(10080):1756–1770. doi:10.1016/S0140-6736(16)32126-2 - DOI - PMC - PubMed
    1. Zhao M, Gönczi L, Lakatos PL, Burisch J. The burden of inflammatory bowel disease in Europe in 2020. J Crohns Colitis. 2021;15(9):1573–1587. doi:10.1093/ecco-jcc/jjab029 - DOI - PubMed
    1. Jess T, Rungoe C, Peyrin-Biroulet L. Risk of colorectal cancer in patients with ulcerative colitis: a meta-analysis of population-based cohort studies. Clin Gastroenterol Hepatol. 2012;10(6):639–645. doi:10.1016/j.cgh.2012.01.010 - DOI - PubMed
    1. Turner D, Ricciuto A, Lewis A, et al. International Organization for the Study of IBD. STRIDE-II: an Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD. Gastroenterology. 2021;160(5):1570–1583. doi:10.1053/j.gastro.2020.12.031 - DOI - PubMed
    1. Cholapranee A, Hazlewood GS, Kaplan GG, Peyrin-Biroulet L, Ananthakrishnan AN. Systematic review with meta-analysis: comparative efficacy of biologics for induction and maintenance of mucosal healing in Crohn’s disease and ulcerative colitis controlled trials. Aliment Pharmacol Ther. 2017;45(10):1291–1302. doi:10.1111/apt.14030 - DOI - PMC - PubMed