According to the researchers, this is the first study to assess an anti-MAdCAM antibody as a potential treatment for ulcerative colitis and contributes to the growing body of evidence that cell adhesion has an important role in this disease and suggests inhibition of cell adhesion mediated by MAdCAM could result in an effective therapy.
A commentary notes that in the study, ~ half of patients had been previously treated with an anti-TNFα agent before inclusion, and remission rates with PF-00547659 were higher in treatment-naive patients than in those previously exposed to an anti-TNFα agent, with an absolute difference ranging from 7.5% to 16% among treatment groups. It points out that in the coming years there will be several therapeutic options with multiple modes of action, including anti-TNFα blockers, anti-adhesion molecules, JAK inhibitors, sphingosine-1-phosphate modulators, and faecal microbiota transplantation. It notes that choice of agent is currently driven by indirect comparisons of efficacy and safety profiles, routes of administration, and costs. It calls for head-to-head comparative trials and strategic studies to assess the best sequences and combinations of treatment. A large phase 3 programme is underway.