Using Drug Discovery and Development to Maintain a Positive Response in the Treatment of IBD

Biologics Discovery

drug discovery
Some patients with irritable bowel disease relapse after an initial positive response to biologic therapy. How can drug discovery help companies develop effective treatments for this disease?
Image source: Flickr CC user Ed Uthman

Inflammatory bowel disease (IBD) affects more than 1.4 million people in the United States alone.1 While IBD is often confused with irritable bowel syndrome, the two conditions are not the same. This isn’t to diminish irritable bowel syndrome, which can cause serious gastrointestinal discomfort. It simply doesn’t lead to the same visible inflammation and damage in the intestines that we usually see in IBD. IBD manifests in various forms, but the two most common—and well-known—types are Crohn’s disease and ulcerative colitis. Cases of Crohn’s disease, in particular, are increasing, supporting the need to find an effective course of treatment for the condition.

At the moment, there are two main ways to treat IBD: medication and surgery. It’s important to note that these options only either address symptoms or complications. For example, some medications target the intestinal inflammation caused by IBD. Others suppress the immune response. Surgery is used to remove affected parts of the digestive tract. Some patients are prescribed antibiotics to deal with bacterial infections that result from the damaged caused by the disease. There are many options for patients suffering from IBD, so if one does not work, many patients can opt to try another avenue. Unfortunately, it also means there is no cure. And until there is, companies should continue to pursue their efforts in biologic drug discovery.

Considerations for Using Biologics in the Treatment of IBD

There are currently several biologics approved by the FDA to treat IBD. Like traditional medication, they either target symptoms or complications associated with the condition. Considering the severity of the inflammation caused by the disease, any alleviation or prevention of damage is a good thing. The downside is that IBD often lasts for a patient’s entire lifetime, with symptoms first exhibiting in the late teens to early 30s. Such long-term use of drug treatments can lead to complications.

In case of biologics used to treat IBD, some patients relapse after showing initial improvement after treatment. This is in addition to people who never experience a favorable response at all. There are a few potential explanations for this lack of continued positive response. The first is patient nonadherence. The second is that the drug is given in too low a concentration to be effective. The third, and most significant, is that the therapy doesn’t address the underlying mechanism of the disease. In fact, because no one knows the true cause of IBD, effective drug discovery remains challenging.

Improving Drug Discovery and Response to IBD-Related Biotherapeutics

Despite the difficulties, there are a few ways to maintain a positive response to IBD therapies:

  • Better drug monitoring to ensure patient adherence
  • Improved dosage amounts and administration schedule to ensure that correct concentration levels are maintained
  • Combination therapy to ensure that no unwanted antibodies are formed in response
  • Use of biologics earlier in treatment

The last suggestion might be the best way to guarantee a positive response, but as of right now it goes against standard practice for treatment. IBD therapy follows a “step up” protocol in which patients first try gentler forms of treatment and then move on to more intense methods if those fail.2

The reasoning for this approach stems from the lack of understanding surrounding the causes of IBD. We don’t even know what the disease is actually attacking and why. We only know that it damages the digestive tract in the process. Figuring out the target of the condition would greatly aid in narrowing down the underlying mechanisms of IBD, which in turn would help with developing treatment.

To uncover the disease mechanism and further aid drug discovery, it may be that researchers will need to diverge from current practice. Presently, IBD-related biotherapeutics are either anti-inflammatories or immunosuppressants. One group, however, is working on a treatment that forms a protective biofilm in the digestive tract. They’re even hoping to develop it as an oral supplement, which is less invasive than the injections required by present therapies.3 Who knows? The reason behind the effectiveness of the biofilm therapy might even hold the secret to the causes of IBD.

Clearly, the biggest hurdle in developing an effective treatment for IBD is the lack of understanding in disease mechanism. But once the causes are fully understood, companies will need to focus their energy on drug discovery. And although discovery plays a large role in the R&D process, it poses several challenges. There are many potential candidates. This has already been evident in the number of accepted treatments for IBD. Imagine how many candidates existed during the early stages of the R&D process. As the number of potential candidates increases, it becomes more difficult to screen them effectively. The data obtained during development and screening can quickly accumulate, making information management and access unwieldy.

The BIOVIA Biologics solution is a suite of tools and applications built on a common platform and designed to help life science firms develop novel biotherapeutics every step of the way, beginning at the drug discovery stage. Included among its many features is biologic modeling, which enables users to move beyond sequence data and into 3D structural modeling. As a result, they can predict critical physical properties of biologic therapeutics, allowing them to screen potential candidates efficiently and optimize promising leads. The solution also boasts effective tools that streamline data management with reliable documentation tools, powerful searching capabilities, and information sharing, all of which are necessary to remain competitive in a crowded field. Please contact us today to learn more.

  1. “Best drugs to affect inflammatory bowel disease,” August 2014, http://www.consumerreports.org/cro/2014/08/best-drugs-to-treat-inflammatory-bowel-disease/index.htm
  2. “Optimal use of biologics in the management of Crohn’s disease,” September 2015, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002580/
  3. “Study Reveals Potential New Oral Treatment for Inflammatory Bowel Disease,” October 28, 2015, http://www.doctorpulse.co/?p=5755

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