Ulcerative colitis causes ongoing inflammation and ulcers in the colon, leading to bleeding, diarrhea, and abdominal pain. About 1 million Americans have it. Treatment has expanded from older immunosuppressants to targeted biologics and small-molecule drugs that can put many people into remission.
What's actually going on in research
Trials are testing JAK inhibitors, anti-integrin antibodies, IL-23 inhibitors, S1P receptor modulators, and stem cell therapies. Many studies compare new drugs to vedolizumab or adalimumab, which are now standard options. Researchers are also pursuing therapies that restore the intestinal barrier and microbiome treatments that address underlying gut imbalances.
JAK inhibitors
Pills like tofacitinib and upadacitinib are FDA-approved for ulcerative colitis and block inflammation inside immune cells. Newer JAK inhibitors are being tested to see if they work faster or have fewer side effects.
IL-23 pathway blockers
Drugs targeting IL-23, a protein that drives intestinal inflammation, showed strong results in Crohn's disease. Trials are now testing whether they work as well in ulcerative colitis.
Microbiome therapies
Studies are testing fecal transplants and engineered bacterial treatments to restore healthy gut bacteria. Early results suggest some people respond, but identifying who benefits remains a challenge.
What to know before you search
Eligibility usually depends on disease severity, how much of the colon is inflamed, response to past treatments, and results from recent colonoscopy.
What types of trials are currently open
- Induction trials — Testing whether a new drug can bring active ulcerative colitis into remission within weeks to months. Often compare the drug to a placebo or standard treatment.
- Maintenance trials — Testing whether a drug keeps people in remission long-term after initial response. May last a year or more.
- Head-to-head trials — Comparing two active drugs directly to see which works better or has fewer side effects.
- Combination trials — Testing whether using two drugs together works better than one alone, especially for people who didn't fully respond to one treatment.
- Biomarker studies — Following people to identify blood or tissue markers that predict who will respond to specific treatments.
Recently added Ulcerative Colitis trials
Phase I Trial of Subcutaneous VDJ010 In Healthy Subjects and Patients With Ulcerative Colitis
This study adopted a multi-center, randomized, double-blind, placebo-controlled, single- and multiple-ascending dose design, using recombinant human IL-2 fusion protein (VDJ010) administered subcutaneously to evaluate its safety, tolerability, pharmacokinetics, and pharmacodynamics in healthy Chinese subjects and patients with ulcerative colitis.
Specific and Novel Approaches to Care of Inflammatory Bowel Disease During Pregnancy: the PREGO Study
IBD pregnancy requires multidisciplinary management, but access to this may be difficult for some, resulting in variation in care which may in turn impair quality of healthcare delivery. We need to devise innovative ways to deliver care to overcome these barriers. The PREGO study will interrogate the value of multidisciplinary care in IBD pregnancy, and test a new virtual-based way of improving access to care.
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