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Part 4 · The future · 16/22

Research at full speed

Scientists have never worked so hard on Crohn's disease and ulcerative colitis. Here is where they are aiming, and what AI is changing.

~60research projects in Phase 2 worldwide
20new molecules in Phase 2 or beyond
16large Phase 3 trials under way, most of them expected in 2028
Research has never been so activeResearchers are attacking the chain of inflammation at points never targeted before, and adding two new steps: repairing the gut wall and tackling scarring. Here is everything currently in trials.
Ph. 3 soon: see “The treatments on the way”Ph. 2 Ph. 1-2 later: see “Future leads”
Upstream: a possible cause

A bacterium (MAP) is suspected in some people with Crohn's. Not proven yet.

In trials
Anti-MAP vaccine Ph. 2Oxford, not yet open to recruitmentRHB-204 Ph. 2 plannedantibiotics
1. The alarm

New: targeting the microbe detector (NOD2, RIPK) and the basic alarms.

In trials
OD-001 Ph. 2RIPK2ABBV-668 Ph. 2RIPK1BI 3032950 Ph. 2TREM-1Lutikizumab Ph. 2IL-1
2. The messengers

A new messenger targeted: TL1A. And the IL-23 receptor blocked by a tablet, or with an injection every 3 to 6 months.

In trials
Tulisokibart Ph. 3TL1ADuvakitug Ph. 3TL1AAfimkibart Ph. 3TL1AIcotrokinra Ph. 3IL-23 receptor, tabletSPY002, SPY003 Ph. 2TL1A, IL-23
3. The relay inside the cell

A more targeted relay than today’s JAK drugs.

In trials
Zasocitinib Ph. 2TYK2
4. Leaving the lymph nodes

A new molecule from the same family as Zeposia and Velsipity.

In trials
Tamuzimod Ph. 2S1P, future uncertain
5. Getting into the gut

The equivalent of Entyvio in a tablet, and a new “key” being targeted (CCR9).

In trials
Emvistegrast Ph. 2α4β7 tabletMORF-057 Ph. 2α4β7 tabletSPY001 Ph. 2α4β7AZD7798 Ph. 2CCR9
6. Inflammation of the gut wall

New: strengthening the body’s natural brakes on inflammation instead of blocking.

In trials
Obefazimod Ph. 3miR-124Omilancor Ph. 3LANCL2ALTB-268 Ph. 2PSGL-1Eltrekibart Ph. 2neutrophils
7. Repair

Helping the gut wall rebuild itself.

In trials
Garutadustat Ph. 2HIF, designed by AI
8. Scarring (strictures)

For the first time, treatments against fibrosis.

In trials
Ontunisertib Ph. 2ALK5PALI-2108 Ph. 1-2PDE4MBF-118 Ph. 2PPARγDuvakitug Ph. 2 plannedTL1A
Metabolism

Tirzepatide + Omvoh (Ph. 3), for people who are overweight.

Two targets in one

JNJ-4804: IL-23 + TNF (Ph. 2b met its goals, Ph. 3 announced). ABBV-466: IL-23 + α4β7 (Ph. 2).

Artificial intelligence is speeding everything up

200 million

protein shapes predicted by AlphaFold, almost all of those known. Knowing the shape of a target means knowing where a drug can latch on. Nobel Prize in Chemistry 2024.

12 months

to find garutadustat, a drug candidate for ulcerative colitis designed by AI, with about 115 molecules tested (according to the company Insilico). Traditional methods take 4 to 5 years on average.

4 years

before diagnosis: in research, a blood test can already pick up signs of Crohn's. One day, we might be able to stop the disease from starting.

What is the point of all this?Treatments that work better, are simpler to take, and are tailored to each person. If a treatment is not working for you today, others are coming: you have not run out of options.