Ulcerative colitis (UC) a type of inflammatory bowel disease (IBD) which is a long term condition that causes inflammation and ulcers in the bowel and rectum which can bleed and produce pus. UC is thought to be caused when the immune system mistakes harmless bacteria inside the bowel as a threat and attacks the tissues of the colon, causing inflammation. The main symptoms of UC include recurring diarrhoea (why may contain blood, mucus or pus), abdominal pain and feeling the need to empty your bowels more frequently. The symptoms of UC often follow a pattern of periods of very mild or no symptoms (remission) followed by periods of increased symptoms (relapse or active disease).
Ustekinumab is a drug which is given as an injection and works by blocking the molecules that are involved in the inflammation which occurs in UC. Ustekinumab is already licenced for use in people with Crohn’s disease, which is another type of IBD. If ustekinumab is licenced this would provide another treatment option for people with moderate to severe active UC.
Obeticholic acid is a modified form of a bile acid. It works by attaching to receptors in the liver and gut called farnesoid X receptors (FXRs) which control the production of bile. By attaching to these receptors, obeticholic acid reduces the production of bile in the liver, preventing it from building up and damaging the liver tissue. FXRs are also involved in the control of inflammation and fibrosis as well as the handling of fats and glucose in the liver which are important processes in the development of NASH. If licensed, obeticholic acid may offer the first pharmacological treatment option for patients with NASH who currently have few effective therapies available.