Maria Abreu, MD: New Approaches for More Crohn's Disease, Ulcerative Colitis Treatments

Many of the same drugs are available for patients suffering from either ulcerative colitis or Crohn’s disease. In fact, the US Food and Drug Administration (FDA) recently approved uskinetinumab to treat ulcerative colitis after approving the drug for Crohn’s disease in 2016.

During the American College of Gastroenterology’s Annual Scientific Meeting (ACG 2019) in San Antonio, Texas, Maria Abreu, MD, director of the Crohn’s & Colitis Center at the University of Miami Health Center, explained in an interview with MD Magazine® why drugs like ustekinumab are so effective and safe at treating either disease and what is needed for more drugs to become available to treat these disorders.

MD Magazine: How important is it to study medications proven to treat Crohn’s disease in patients with ulcerative colitis and vice versa?

Abreu: For all intents and purpose most of the drugs we have for one disease work in the other disease. Sometimes to the same overall extent sometimes a little less.

Possibly 1 of the more recent examples of something where that's not the case is tofacitinib, which is effective and ulcerative colitis and was tested in Crohn's disease and was not effective.

I don't actually think it's dosing, I'm not sure what it is. It's not readily apparent what it is. We know however, as a class of drugs these JAK inhibitors, which is what tofa is, work in Crohn's disease. There could just be subtleties and the mechanism of action or bioavailability that make these drugs work differently in different diseases.

I do think that that it would be great in a perfect world that these clinical trials could be done more nimbly. If the question is directed at why are they staggered, some of it is cost.

Obviously putting on a clinical trial is a very expensive endeavor and therefore a pharmaceutical company must need to decide which one's going to be the winner or which one's more likely to be successful.

Kind of looking at things that I don't really know that well in terms of the landscape. Nevertheless, I think that it for the benefit of our patients, I really wish that things could be more nimble.

People are talking about platform clinical trial designs where if something's not working you move on to the next therapy. I think that would be really genius, especially if we could get pharmaceutical companies to collaborate to do that.

At the end of the day, we have so many patients ill-served who are sick and really need new therapies.