Budesonide granules for induction of remission in lymphocytic colitis – first line

Dapagliflozin blocks the action of a protein in the kidneys called sodium-glucose cotransporter 2 (SGLT2). As blood is filtered by the kidneys, SGLT2 stops glucose in the bloodstream from being passed out into the urine. By blocking the action of SGLT2, dapagliflozin causes the kidney to pass out more glucose in the urine, thereby reducing the levels of glucose in the blood. SGLT2 inhibitors have exhibited beneficial effects on kidney function in those with diabetes and more recently has shown improvements in kidney function and all-cause mortality in those with CKD without a diabetes. If licensed, dapagliflozin may provide a treatment option specifically for people with CKD.

Etrolizumab is a new monoclonal antibody (an immune protein) delivered by subcutaneous injection. The treatment works by targeting molecules called integrins to control the immune response and prevent the accumulation of immune molecules, which cause inflammation in individuals with a form of ulcerative colitis where inflammation is not mediated by a signalling protein called tumour necrosis factors (TNF) alpha (‘non-TNF-α’) and who are therefore intolerant to TNF blockers. This represents a new target group as current therapies focus mainly on anti-TNF inflammation. In one study, etrolizumab showed a greater reduction of intestinal lymphocyte infiltration in comparison to standard treatment.

Maralixibat is an orally administered drug that is expected to reduce the level of bile acids. It is expected to interfere with the process by which most bile acids in the intestines are recovered and delivered back to the liver through the blood, thereby reducing the liver damage and itching seen in patients with PFIC2. If licensed, maralixibat will provide the first disease-modifying treatment option for patients with PFIC2, a disease of unmet clinical need.

Filgotinib is in clinical development for the treatment of patients with moderately to severely active ulcerative colitis. Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation and ulcers in the bowel and rectum which can cause diarrhoea, abdominal pain and faecal urgency or incontinence. The symptoms of ulcerative colitis often follow a pattern of relapse and remission where they have periods of none or mild symptoms followed by periods of increased symptoms flare-up (‘active’). There are no curative therapies for ulcerative colitis and current treatment aims to relieve symptoms during a flare-up and maintain remission by preventing symptoms from returning.