Time-stamps:
1:14 JAK discovery and biology
3:42 Introducing the drugs
7:22 JAK inhibitors for UC
10:17 JAK inhibitors for Crohn's disease
13:46 Safety
15:26 ORAL surveillance
17:27 PRAC 20
19:34 Positioning
21:52 Future Directions
24:44 Summary

A new generation of medicines for inflammatory bowel disease has entered the clinic over the past few years. These JAK inhibitors are small molecules, not biologics.

Tofacitinib has been in the clinic to treat UC patients for 4 years, and to great effect. I have been really struck by the speed of onset of action, obviating the need to use corticosteroids in most patients, and the efficacy in patients previous exposed to anti-TNF therapy.

This year filgotinib and upadacitinib have been approved for UC. Next year we will start to use upadacitinib for Crohn's disease too.

Video Editing by @IBDNathan Nathan Constantine-Cooke
Graphic design by @ErikRva

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PROFESSOR CHARLIE W LEES FRCP(Ed) PhD
Charlie is Professor of Gastroenterology at the University of Edinburgh, a UK Research and Innovation Future Leaders Fellow (UKRIFLF) and Consultant Gastroenterologist in the Edinburgh IBD Unit. His clinical, teaching and research interests have been focused on inflammatory bowel disease (IBD) since 2003. He was awarded his PhD in the Genetics of IBD and the prestigious UEG Rising Star award in Gastroenterology, both in 2009. Following this he spent 10 years working as a full-time consultant gastroenterologist leading an increasingly busy and complex IBD clinic.

In 2019 Charlie was awarded a personal fellowship from UKRI - worth £1.7m - that enabled his transition to full-time academic gastroenterology. His research team are based in the Centre for Genomics and Experimental Medicine within the Institute of Genetics and Cancer in Edinburgh.

Charlie’s core mission is to improve outcomes for people living with IBD.

His team are working on predicting outcomes in IBD, using routinely collected NHS data (the Lothian IBD Registry) and dedicated multi-modal prospective cohorts to build predictive models.

He is Chief Investigator of the PREdiCCt study, which has recruited 2650 patients in clinical remission with detailed baseline phenotyping (clinical, psycho-social, lifestyle, environmental, dietary, microbiome and genomics) and a minimum of 24 months longitudinal follow-up.

Conflicts of Interest
Professor Charlie Lees has acted as a speaker and/or consultant to Abbvie, Janssen, Takeda, Pfizer, Galapagos, GSK, Gilead, Vifor Pharma, Ferring, Dr Falk, BMS, Boehringer Ingelheim, Novartis, Sandoz, Celltrion, Fresnius Kabi, Tillotts, Trellus Health and Iterative Scopes.

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