Filgotinib bei Colitis ulcerosa: ein Review

Ulcerative colitis is a chronic inflammatory bowel disease affecting the colon. The most common symptoms are bloody and mucous diarrhea, urge to defecate, and abdominal pain. These symptoms often represent a significant health impairment for those affected.

Filgotinib is a medication that is used orally to treat moderately to severely active ulcerative colitis. It belongs to the class of Janus kinase inhibitors and preferentially blocks the enzyme Janus kinase 1, which maintains cytokine-mediated inflammatory processes in ulcerative colitis. The efficacy and safety of filgotinib compared with placebo for the treatment of moderately to severely active ulcerative colitis were investigated in the SELECTION study over 58 weeks. Filgotinib 200 mg led to a rapid improvement in clinical symptoms in significantly more patients within the first 3–4 days of treatment compared with placebo. It also led to a higher rate of clinical, endoscopic, and histological remission after both 10 and 58 weeks. The safety profile of the substance was evaluated in a long-term study. Nausea, upper respiratory tract and urinary tract infections, dizziness, and lymphopenia were reported most frequently. The incidences of severe infections, thrombosis, and serious cardiac side effects were low and comparable between filgotinib and placebo.

Special features of filgotinib are the once-daily oral application, the good controllability owing to the short half-life, and the absence of immunogenicity in contrast to the biologics.