Guest Gilaad G. Kaplan discusses Risankizumab for ulcerative colitis with JAMA Editor. Topics include personalized therapy with monoclonal antibodies targeting IL-23 pathway, phase 3 trial results showing higher remission rates, complexities in comparing risankizumab to placebo, and the importance of precision medicine in treatment strategies.
Ulcerative colitis treatment challenges demand precision medicine and biomarker-guided decisions for optimal outcomes.
Risankizumab showcases significant efficacy in inducing and maintaining remission in ulcerative colitis patients.
Deep dives
Challenges in Ulcerative Colitis Treatment
Treating ulcerative colitis remains a challenge despite the availability of various medications. Patients with moderate to severe disease face hospitalizations and potentially colectomy. The primary goals of treatment are to induce remission and then maintain it to prevent reactivation of inflammation. For mild disease, 5-aminosalicylates are commonly used, while more advanced therapies target the pathogenesis of ulcerative colitis for moderate to severe cases.
Role of Different Drug Classes in Ulcerative Colitis Treatment
Various drug classes, such as biologics and oral small molecules, are utilized in treating moderate to severe ulcerative colitis. The FDA has approved drugs targeting pathways like TNF alpha, alpha4 beta7 integrins, IL-12, IL-23, and newer therapies like Rizankizumab. The diversity of available drugs reflects the lack of a single highly effective and durable treatment for all ulcerative colitis patients.
Efficacy of Rizankizumab in Induction and Maintenance Studies
A randomized control study on Rizankizumab demonstrated its efficacy for inducing and maintaining remission in ulcerative colitis patients. The study comprised an induction component (INSPIRE) and a maintenance component (COMMAND). Results showed significantly higher rates of clinical and endoscopic remission in patients receiving Rizankizumab compared to placebo. The study highlighted the need for precision medicine and biomarkers to guide treatment decisions in ulcerative colitis.
Ulcerative colitis can significantly decrease quality of life. A third of patients have persistent symptoms with tumor necrosis factor inhibitors and nearly 1 in 5 patients will be hospitalized within 5 years of diagnosis. Author Gilaad G. Kaplan, MD, MPH, of the University of Calgary joins JAMA Associate Editor John M. Inadomi, MD, to discuss Risankizumab for Ulcerative Colitis. Related Content: