The sphingosine-1-phosphate receptor agonist etrasimod in ulcerative colitis

Advanced therapies have transformed the management of ulcerative colitis, but subgroups of patients do not respond to available treatments and have systemic side-effects, indicating the necessity for further therapeutic approaches. 1 Raine T Bonovas S Burisch J et al. ECCO guidelines on therapeutics in ulcerative colitis: medical treatment. J Crohn's Colitis. 2022; 16: 2-17 Crossref PubMed Scopus (97) Google Scholar , 2 Atreya R Neurath MF Mechanisms of molecular resistance and predictors of response to biological therapy in inflammatory bowel disease. Lancet Gastroenterol Hepatol. 2018; 3: 790-802 Summary Full Text Full Text PDF PubMed Scopus (43) Google Scholar Sphingosine-1-phosphate (S1P) receptor agonists bind to S1P receptor-expressing activated lymphocytes, leading to retention of lymphocytes within the lymph nodes, peripheral lymphopenia, and inhibition of lymphocyte trafficking to sites of inflammation. 3 Pérez-Jeldres T Tyler CJ Boyer JD et al. Targeting cytokine signaling and lymphocyte traffic via small molecules in inflammatory bowel disease: JAK inhibitors and S1PR agonists. Front Pharmacol. 2019; 10: 212 Crossref PubMed Scopus (74) Google Scholar , 4 Verstockt B Vetrano S Salas A et al. Sphingosine 1-phosphate modulation and immune cell trafficking in inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. 2022; 19: 351-366 Crossref PubMed Scopus (17) Google Scholar Etrasimod as induction and maintenance therapy for ulcerative colitis (ELEVATE): two randomised, double-blind, placebo-controlled, phase 3 studiesEtrasimod was effective and well tolerated as an induction and maintenance therapy in patients with moderately to severely active ulcerative colitis. Etrasimod is a treatment option with a unique combination of attributes that might address the persistent unmet needs of patients with ulcerative colitis. Full-Text PDF Open Access