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Pharmacotherapy of Inflammatory Bowel Disease
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Pharmacotherapy of Inflammatory Bowel Disease

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: 25 May 2025 | Viewed by 7468

Special Issue Editor

Prof. Dr. Wolfgang Kruis

E-Mail Website
Guest Editor
Em. Head of the Clinic for Internal Medicine and Gastroenterology, Protestant Hospital Kalk, University of Cologne, Cologne, Germany
Interests: inflammatory bowel disease (IBD); Crohn´s disease; ulcerative colitis; controlled trials in IBD; observations in rare manifestations of IBD; pharmacological studies; studies on pathogenesis of IBD
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Successful treatment of Inflammatory Bowel Diseases (IBD) is characterised by two challenges: The wide range of miscellaneous clinical manifestations requiring individual therapeutic strategies and the permanent advent of novel therapeutic compounds. On grounds of ongoing scientific work in the pathogenesis of IBD, development of pharmacological immune modulation became a predominant target of research groups and the parmaceutical industy. Starting with classic immunosuppression the development of antibodies, oligonucelotides and recently  also small molecules has substantially extended the range of pharmaceuticals for IBD. In addition, traditional drugs have gained new insights which make these products still valuable  remedies for our daily clinical work.

Multifaceted new therapeutic options increase the chances for patients and physicians in the clinical setting. But this  increase has to be accompanied by skill enhancement based on the scientific discussion as published by specialists in the field.

The aim of this Special Issue is to offer to our readers short but comprehensive and updated reviews on the conservative management of many manifestations of IBD.

Prof. Dr. Wolfgang Kruis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmaceuticals is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Treatment of Crohn's Disease
  • treatment of ulcerative Colitis
  • mesalazine for ulcerative colitis
  • mesalazine for Crohn's Disease
  • antibody strategies in IBD
  • small molecules for IBD
  • conservative managenment of Crohn's fistula
  • therapy for extraintestinal manifestations
  • new endpoints for treatment

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Published Papers (4 papers)

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Research

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9 pages, 235 KiB  
Article
The Efficacy, Safety, and Persistence of Therapy after Non-Medical Switching from an Originator Adalimumab in Inflammatory Bowel Disease: Real-Life Experience from Two Tertiary Centres
by Teodora Spataru, Remus Popescu, Monica State, Mihai Pahomeanu, Bogdan Mateescu and Lucian Negreanu
Pharmaceuticals 2024, 17(10), 1319; https://doi.org/10.3390/ph17101319 - 2 Oct 2024
Cited by 1 | Viewed by 1093
Abstract
During the last two decades, an increased number of molecules with multiple mechanisms of action have been approved for the treatment of inflammatory bowel disease (IBD), with a substantial increase in the costs related to therapy, which has become a concern for payers, [...] Read more.
During the last two decades, an increased number of molecules with multiple mechanisms of action have been approved for the treatment of inflammatory bowel disease (IBD), with a substantial increase in the costs related to therapy, which has become a concern for payers, regulators, and healthcare professionals. Biosimilars are biologic medical products that are highly structurally similar to their reference products; have no clinically meaningful differences in terms of immunogenicity, safety, or effectiveness; and are available at a lower price. Materials and Methods: This was an observational prospective study conducted in two IBD centres in Bucharest and included 53 patients, 27 male (M) and 26 female (F), diagnosed with IBD according to standard clinical, endoscopic, radiological, and histological criteria, who were non-medically switched at the indication of the National Insurance House to a biosimilar of Adalimumab. Aims: The aim was to determine the rates of clinical remission, adverse effects, and treatment persistence at one year. Results: No significant differences were found in terms of the faecal calprotectin (FC) and C-reactive protein (CRP) levels 6 and 12 months after changing from the originator biologic treatment to a biosimilar. Only one patient required a change in their biological treatment following the clinical and biological loss of response. The main adverse effect reported by the patients was pain at the injection site. Of the 53 patients, only 2 reported pain at the injection site, and 1 patient reported experiencing abdominal pain and rectal bleeding immediately after the switch, but no recurrence was observed clinically or endoscopically. Conclusions: This observational study is the first to be carried out in Romania that shows that, after a non-medical switch, biosimilars of Adalimumab are as efficient and safe as the originator Adalimumab in the clinical treatment of patients with IBD. Full article
(This article belongs to the Special Issue Pharmacotherapy of Inflammatory Bowel Disease)

Review

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32 pages, 697 KiB  
Review
Drug Development in Inflammatory Bowel Diseases: What Is Next?
by Lorenzo Petronio, Arianna Dal Buono, Roberto Gabbiadini, Giulia Migliorisi, Giuseppe Privitera, Matteo Ferraris, Laura Loy, Cristina Bezzio and Alessandro Armuzzi
Pharmaceuticals 2025, 18(2), 190; https://doi.org/10.3390/ph18020190 - 30 Jan 2025
Viewed by 1842
Abstract
Background/Objectives: Inflammatory bowel diseases (IBDs), which include Crohn’s disease (CD) and ulcerative colitis (UC), are chronic conditions requiring long-term therapy to maintain remission and improve quality of life. Despite the approval of numerous drugs, IBD continues to present treatment challenges. This review [...] Read more.
Background/Objectives: Inflammatory bowel diseases (IBDs), which include Crohn’s disease (CD) and ulcerative colitis (UC), are chronic conditions requiring long-term therapy to maintain remission and improve quality of life. Despite the approval of numerous drugs, IBD continues to present treatment challenges. This review aims to summarize novel therapeutic target agents in phases II and III of development, including sphingosine-1-phosphate receptor modulators (S1P), anti-interleukin-23 (IL-23), and other small molecules and monoclonal antibodies currently under investigation (e.g., anti-TL1A, obefazimod, NX-13, RIPK-inhibitors). Methods: A comprehensive literature search was conducted up to December 2024 to identify relevant articles published in English over the past three–five years, focusing on phase II/III studies for UC and CD. The search included databases such as PubMed, Google Scholar, and the ClinicalTrials.gov portal. Results: Clinical trials underline the potential of novel immunomodulators, including anti-TL1A, obefazimod, NX-13, RIPK inhibitors, and anti-IL-23p19 agents, as promising therapeutic options for IBD. Anti-IL23p19 therapies, such as risankizumab and mirikizumab, alongside guselkumab, exemplify this class’s growing clinical relevance. While some are already in clinical use, others are nearing approval. Conclusions: Ongoing research into long-term safety and the development of personalized treatment strategies remains pivotal to enhance outcomes. Patient stratification and the strategic positioning of these therapies within the expanding treatment landscape are critical for optimizing their clinical impact. Full article
(This article belongs to the Special Issue Pharmacotherapy of Inflammatory Bowel Disease)
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21 pages, 634 KiB  
Review
Advancing Therapeutic Targets in IBD: Emerging Goals and Precision Medicine Approaches
by Lucia Centanni, Clelia Cicerone, Fabrizio Fanizzi, Ferdinando D’Amico, Federica Furfaro, Alessandra Zilli, Tommaso Lorenzo Parigi, Laurent Peyrin-Biroulet, Silvio Danese and Mariangela Allocca
Pharmaceuticals 2025, 18(1), 78; https://doi.org/10.3390/ph18010078 - 10 Jan 2025
Cited by 1 | Viewed by 1793
Abstract
Inflammatory bowel diseases (IBD) including Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, relapsing conditions characterized by dysregulated immune responses and persistent intestinal inflammation. This review aims to examine new potential therapeutic targets in IBD starting from the STRIDE-II statements. Key targets [...] Read more.
Inflammatory bowel diseases (IBD) including Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, relapsing conditions characterized by dysregulated immune responses and persistent intestinal inflammation. This review aims to examine new potential therapeutic targets in IBD starting from the STRIDE-II statements. Key targets now include clinical remission, endoscopic remission, and biomarker normalization (such as C-reactive protein and fecal calprotectin). Moreover, histologic remission, transmural remission, and in the future molecular targets are emerging as important indicators of sustained disease control. The treatment goals for inflammatory bowel disease are varied: to relieve symptoms, prevent permanent intestinal damage, promote inflammation remission, and minimize complications. Consequently, the therapeutic targets have evolved to become broader and more ambitious. Integrating these advanced therapeutic targets has the potential to redefine IBD management by promoting deeper disease control and improved patient outcomes. Further research is essential to validate these strategies and optimize their clinical implementation. Full article
(This article belongs to the Special Issue Pharmacotherapy of Inflammatory Bowel Disease)
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Other

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17 pages, 2845 KiB  
Systematic Review
Optimizing Treatment Outcomes in Crohn’s Disease: A Comprehensive Systematic Review and Meta-Analysis of Regenerative Therapies with Emphasis on Platelet-Rich Plasma
by Marcia Carolina Mazzaro, Ana Emília Carvalho de Paula, Livia Bitencourt Pascoal, Livia Moreira Genaro, Isabela Machado Pereira, Bruno Lima Rodrigues, Priscilla de Sene Portel Oliveira and Raquel Franco Leal
Pharmaceuticals 2024, 17(11), 1519; https://doi.org/10.3390/ph17111519 - 12 Nov 2024
Viewed by 2060
Abstract
Background/Objectives: Crohn’s disease (CD) is a chronic inflammatory disorder that significantly affects patients’ quality of life; conventional treatments often provide limited relief. Methods: This systematic review and meta-analysis explored the potential of regenerative therapies, particularly platelet-rich plasma (PRP), as an adjunctive treatment for [...] Read more.
Background/Objectives: Crohn’s disease (CD) is a chronic inflammatory disorder that significantly affects patients’ quality of life; conventional treatments often provide limited relief. Methods: This systematic review and meta-analysis explored the potential of regenerative therapies, particularly platelet-rich plasma (PRP), as an adjunctive treatment for CD. The study protocol was registered with PROSPERO (CRD42024576683), and a comprehensive search was conducted across major databases, such as PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. The search included terms related to CD and PRP. Studies assessing the efficacy of PRP in CD treatment were selected. Statistical analysis was conducted using the PICO framework with R software (version 4.3.2) and meta-package. Results: Of the 29 studies identified, 10 met the inclusion criteria, comprising pilot studies and controlled trials. Nine studies focused on Crohn’s disease perianal fistulas (CDPF), and one focused on colonic CD. Among 138 patients with CDPF, 82.44% showed some fistula healing after PRP treatment, with 48.05% achieving complete resolution. In a sub-analysis, combining PRP with a stromal vascular fraction (SVF) resulted in a 58.62% complete healing rate, whereas combining PRP with adipose-derived stem cells (ASCs) showed even higher efficacy at 85.89%. PRP treatment alone resulted in a lower complete healing rate of 38.51%. PRP was well tolerated, with minor side effects such as localized pain. Conclusions: These findings suggest that PRP, especially when combined with stem cells, offers a promising new approach for treating CD. However, larger trials are needed to confirm its long-term benefits and refine its clinical applications. Full article
(This article belongs to the Special Issue Pharmacotherapy of Inflammatory Bowel Disease)
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