David Rubin, MD, on New and Emerging Therapies for IBD

In this video, David Rubin, MD, discusses his presentation at the virtual Advances in Inflammatory Bowel Disease 2020 regional meeting July 25 on new and emerging therapeutics for the treatment of inflammatory bowel diseases. 

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David Rubin, MD, is codirector of the Digestive Diseases Center at UChicago Medicine. 


David Rubin:  It's David Rubin in Chicago. If you were with me for my last presentation, you learned all about the new therapies that are in development for treating patients with Crohn's and ulcerative colitis.

We have a very rich pipeline. In fact, one of the biggest challenges we have is getting enough patients in clinical trials to actually finish our studies and know which treatments are going to work best. But it is a very optimistic near‑term and longer‑term future in managing IBD.

I covered the newer anti‑integrin therapies, like etrolizumab, and thinking more about how that therapy might offer an additional management option for some of our patients.

I covered the emerging anti‑p19, IL‑23 inhibitor therapies and what we've already learned about them in plaque psoriasis and why these might even be better than our current anti‑p40, IL‑12, IL‑23 inhibitor, ustekinumab, and how excited we are to have these as new options for our patients.

Then I spoke a bit about some of the newer JAK inhibitors, the selective JAK1 inhibitors, that offer some benefit for Crohn's disease patients as well as some of the newer considerations regarding JAK inhibition, not just for inflammatory bowel disease patient, but even thinking about how they might be useful in patients who are in the inflammatory phase of COVID.

I spoke about the novel class of S1P receptor modulators, which essentially trap activated lymphocytes in lymph nodes and offer a novel‑oral mechanism for management, and potentially a very safe option that will be coming; the topical TLR9 inhibitor, actually agonist, that triggers a control of inflammation through a topical strategy delivered as an enema.

The PDE4 inhibitor, apremilast, which had very nice results in a Phase 2 study in UC but has not been progressing further in its development, but the mechanism is of great interest to us, and of course, the therapy is available for psoriasis.

I ended by talking about some of the microbial therapies, both what we've learned about fecal microbiota transplant, which we're now calling intestinal microbiota transfer, then the first microbial‑based therapy, the SCR‑287 from series, that is now finished its Phase 2 treatment strategy in ulcerative colitis and has their Phase 1 paper in press right now in gastroenterology.

A very rich discussion, lots of new therapies, and mechanisms. I tried to tie it all together with how we might think about using these therapies in our patients, now and in the near future.