Miguel Regueiro, MD: Let's talk about treatment options that we have for IBD [inflammatory bowel disease], and we've already talked about therapeutic response and goals and predictors of treatment. Marla, I'll kick it off by simply asking you for an overview. What are the biologic classes available for Crohn disease and ulcerative colitis?
Marla C. Dubinsky, MD: With regard to the biologic classes that we have available to us, we'll start with the one that's been around the longest, which is the anti–tumor necrosis factor [anti-TNF] class, and we have a number of those that fit into this class. For Crohn disease, we've got infliximab, adalimumab, and certolizumab. For ulcerative colitis, we have adalimumab, infliximab, and golimumab. So we have 3 for each of them that are used differently: infliximab is intravenous and the others are subcutaneous mechanism of delivery. That's the anti-TNF class.
In terms of the anti-integrin class, the one we have available to us is vedolizumab, which is an alpha-4 beta-7 monoclonal antibody. The third class is ustekinumab, which is an IL-12 [interleukin-12]/IL-23–targeted monoclonal antibody. What’s interesting is that you can see that all 3 go after different cell types, which is very interesting as we talked earlier about this precision medicine approach, and how are we going to figure out which approach it will be.
I also want to highlight that our future will also include other monoclonal antibodies, and one that's going to be closest to reality will be within that family of IL-12/23, which is moving toward what we call the p19, or the IL-23 blockade only. That is going to be within our future quite a bit, hopefully in the coming years.
That's the overarching description of the biologic classes that we have available to us now.
Transcript Edited for Clarity