Strategies for Modulating Intestinal Leukocyte Migration in IBD: A Focus on Oral Selective Sphingosine 1-Phosphate Receptor Modu
Inflammatory bowel disease (IBD), which comprises Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic and progressive illness that produces not only painful symptoms but also structural damage to the gastrointestinal (GI) tract. In years past, clinicians were able to treat only the inflammation and symptomatic manifestations of IBD and did not have the tools with which to alter the natural history of the disease. The advent of monoclonal antibodies targeting tumor necrosis factor alpha (TNFα) and the proliferation of newer targeted therapies for the treatment of IBD, however, have resulted in a paradigm shift away from the traditional step-care approach to therapy focused primarily on symptom alleviation in favor of a top-down approach more likely to induce and maintain remission and mucosal healing (MH). Earlier, more aggressive treatment has been shown to improve outcomes, significantly delaying disease progression, GI complications, and the need for surgery.
While TNFα inhibitors remain an important option for many patients with moderate to severe IBD, the rapidly expanding IBD treatment armamentarium offers vastly improved opportunities to achieve treatment goals—but it also complicates treatment decisions. Between- and within-class distinctions of newer and emerging targeted therapies create a knowledge gap that clinicians must overcome to be prepared to provide the most efficient, up-to-date, and personalized care to each patient. Leukocyte trafficking agents have shown promise in the regulation of leukocyte adhesion infiltration, leading to an inhibition of IBD pathogenesis. These newer and emerging agents consist of several biologics and small molecule drugs including anti-α4 integrins and associated receptors, intercellular adhesion molecule 1 (ICAM-1) and mucosal vascular address in cell adhesion molecule 1 (MAdCAM-1) inhibitors, and sphingosine 1-phosphate (S1P) receptor modulators. Emerging S1P agents, in particular, may be an optimal choice for first- or second-line therapy due to their innovative mechanism of action, favorable efficacy and safety profile, and oral route of administration.
David T. Rubin, MD, FACG
Professor of Medicine
University of Chicago Medicine
Provided by HMP Education, an HMP Global company.
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Designed and certified for the entire IBD healthcare team and includes education for gastroenterologists, pediatric gastroenterologists, surgeons, physicians, PhDs, researchers, pharmacists, nurse practitioners, physician assistants, gastroenterology nurses, and residents/fellows/students.
After participating in this activity, learners should be able to:
- Describe molecular pathways involved in IBD pathogenesis that represent potential therapeutic targets for novel agents
- Evaluate the potential role of emerging S1P receptor modulators for improved IBD outcomes, with an emphasis on mechanism of action, safety and efficacy, and route of administration
To be eligible for credit, participants must complete the online activity and the evaluation. Upon completing the activity, there will be instructions on how to complete the evaluation and print a certificate or other documentation of credit.
Release Date: January 11, 2022
Expiration Date: January 11, 2023
Estimated Time to Complete: 45 Minutes
There is no fee associated with this activity.
EDUCATION GRANT SUPPORT
HMP Education would like to thank the following company who has supported this program through an educational grant: Bristol-Myers Squibb
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David T. Rubin: Consultant - AbbVie, Abgenomics/Altrubio, Allergan, Inc, Arena, Bellatrix, Boehringer Ingelheim, Bristol-Myers Squibb, CDx Diagnostics, Celgene, Check-Cap, Dizal, GalenPharma/Atlantica, Genentech/Roche, Gilead Sciences, Ichnos Sciences, InDex, Iterative Scopes, Janssen, Lilly, Materia Prima, Narrow River Mgmt, Pfizer, Prometheus Laboratories, Reistone, Takeda, Techlab; Grant/Research Support - Takeda; Other - American College of Gastroenterology, Cornerstones Health, GoDuRn, LLC
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