Currently available approaches for managing ulcerative colitis
Expanded Treatment Options for Ulcerative Colitis in 2023 and Beyond
Ulcerative colitis (UC), a type of inflammatory bowel disease (IBD), has seen significant advancements in treatment options in recent times. The Food and Drug Administration (FDA) has approved several new medications to help manage moderate to severe UC cases.
The latest FDA-approved medications for UC treatment in 2023 and beyond include Etrasimod (Velsipity), Mirikizumab, Risankizumab (Skyrizi), and Upadacitinib (Rinvoq).
Etrasimod was approved by the FDA in October 2023 for moderately to severely active UC in adults. It is a sphingosine-1-phosphate (S1P) receptor modulator that targets receptors 1, 4, and 5, distinct from the earlier S1P modulator ozanimod, which targets receptors 1 and 5. Etrasimod does not require initial dosage titration unlike ozanimod[1].
Mirikizumab received FDA approval in October 2023 for moderate to severe UC. It is an IL-23 inhibitor, representing a newer class of biologics for UC treatment[2].
Risankizumab (Skyrizi) was approved in June 2024 for moderate to severe UC, establishing it as the first IL-23 inhibitor approved for this indication. It is part of a strong portfolio of immunomodulators expanding in the inflammatory bowel disease (IBD) market[2][3].
Upadacitinib (Rinvoq) was FDA-approved earlier in March 2022 for moderately to severely active UC in adults. It is a Janus kinase (JAK) inhibitor with selective activity primarily targeting JAK1, contributing to its efficacy in UC therapy[3][4].
These new agents reflect ongoing advancements in targeted therapies for UC, offering options beyond traditional immunosuppressants and TNF-alpha inhibitors. The introduction of these drugs represents distinct mechanisms—S1P modulation, IL-23 inhibition, and JAK inhibition—broadening personalized treatment approaches for moderate to severe UC.
In addition to these new medications, dietary changes can play a role in managing UC symptoms and promoting overall health. The IBD diet emphasizes prebiotics, probiotics, good nutrition, and avoidance of inflammatory foods. Researchers are continuously looking into new treatments for UC, including those that aim to correct imbalances in bacteria.
It is important to note that herbal medicines and complementary therapies do not cure UC, but some may provide relief from symptoms. However, people should be cautious of any therapy that promises a cure for UC. Traditional Chinese Medicine (TCM) has shown promise in helping UC symptoms in some studies, but more research is needed.
For mild to moderate UC cases, healthcare professionals often prescribe oral or rectal aminosalicylates. In severe cases, a healthcare professional may recommend the removal of the colon. For moderate to severe UC cases, healthcare professionals may prescribe corticosteroids, immunosuppressants like thiopurines, or biologics such as anti-integrins, Janus kinase inhibitors, and anti-tumor necrosis factor agents.
The Crohn's & Colitis Foundation identifies three main treatment options for UC: medications, diet and nutrition, and surgery. Continue to follow the treatment guidelines agreed upon with a doctor when considering dietary changes or complementary therapies.
References:
[1] FDA approves Etrasimod for UC
[2] FDA approves Mirikizumab for UC
[3] FDA approves Risankizumab for UC
[4] FDA approves Upadacitinib for UC
[5] Latest FDA Guideline Changes for UC
A nutritionist may advise UC patients to follow an IBD diet, which includes prebiotics, probiotics, good nutrition, and the avoidance of inflammatory foods, as part of managing symptoms and promoting overall health. Science continues to explore new nutrition-based treatments for UC, aiming to correct imbalances in bacteria.
As the health-and-wellness industry evolves, therapies-and-treatments for UC are expanding beyond traditional immunosuppressants and TNF-alpha inhibitors, with targeted options like S1P modulation, IL-23 inhibition, and JAK inhibition now available, reflecting advancements in personalized treatments for moderate to severe UC.
