Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2026, Vol. 31 ›› Issue (3): 392-399.doi: 10.12092/j.issn.1009-2501.2026.03.011
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Furui WANG1,2(
), Tian HUANG1,2, Wenli JIANG1,2, Zenan HU2,*(
)
Received:2024-11-26
Revised:2025-01-21
Online:2026-03-26
Published:2026-04-03
Contact:
Zenan HU
E-mail:wangfurui0918@163.com;huzn@lzu.edu.cn
CLC Number:
Furui WANG, Tian HUANG, Wenli JIANG, Zenan HU. Therapeutic advances in small-molecule drugs for moderate-to-severe ulcerative colitis[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(3): 392-399.
| 药物名称 | 作用机制 | 用法 | 获批情况 | 全球阶段 | 中国阶段 |
| Tofacitinib | JAK抑制剂 | 口服 | 中重度UC(2018,FDA) | 批准上市 | 暂未发现相关报道 |
| Filgotinib | 选择性JAK1抑制剂 | 口服 | 中重度UC(2021,EMA) | 批准上市 | Ⅲ期临床 |
| Upadacitinib | 选择性JAK1抑制剂 | 口服 | 中重度UC(2022,FDA) | 批准上市 | 批准上市 |
| Ozanimod | S1PR调节剂 | 口服 | 中重度UC(2021,FDA) | 批准上市 | 批准上市 |
| Etrasimod | S1PR调节剂 | 口服 | 中重度UC(2023,FDA) | 批准上市 | Ⅲ期临床 |
Table 1 Small molecule drug approved for the treatment of patients with moderate to severe UC
| 药物名称 | 作用机制 | 用法 | 获批情况 | 全球阶段 | 中国阶段 |
| Tofacitinib | JAK抑制剂 | 口服 | 中重度UC(2018,FDA) | 批准上市 | 暂未发现相关报道 |
| Filgotinib | 选择性JAK1抑制剂 | 口服 | 中重度UC(2021,EMA) | 批准上市 | Ⅲ期临床 |
| Upadacitinib | 选择性JAK1抑制剂 | 口服 | 中重度UC(2022,FDA) | 批准上市 | 批准上市 |
| Ozanimod | S1PR调节剂 | 口服 | 中重度UC(2021,FDA) | 批准上市 | 批准上市 |
| Etrasimod | S1PR调节剂 | 口服 | 中重度UC(2023,FDA) | 批准上市 | Ⅲ期临床 |
| 1 |
Le Berre C, Honap S, Peyrin-Biroulet L, et al. Ulcerative colitis[J]. Lancet, 2023, 402 (10401): 571- 584.
doi: 10.1016/S0140-6736(23)00966-2 |
| 2 |
周健华, 陈利国, 许青芸, 等. 溃疡性结肠炎与血瘀证[J]. 长春中医药大学学报, 2016, 32 (3): 495- 497.
doi: 10.13463/j.cnki.cczyy.2016.03.020 |
| 3 |
Du L, Ha C. Epidemiology and pathogenesis of ulcerative colitis[J]. Gastroenterol Clin North Am, 2020, 49 (4): 643- 654.
doi: 10.1016/j.gtc.2020.07.005 |
| 4 |
郑一歌, 翟茜, 高巍, 等. 针刺调节肠道菌群治疗部分相关疾病的研究进展[J]. 长春中医药大学学报, 2024, 40 (8): 928- 933.
doi: 10.13463/j.cnki.cczyy.2024.08.024 |
| 5 |
Quiroz-Cruz S, Posada-Reyes B, Alatorre-García T, et al. Genetic polymorphisms present in IL10, IL23R, NOD2, and ATG16L1 associated with susceptibility to inflammatory bowel disease in mexican population[J]. Eur J Gastroenterol Hepatol, 2020, 32 (1): 10- 16.
doi: 10.1097/MEG.0000000000001540 |
| 6 |
吕彦青, 李嘉杰, 刘坤禹, 等. 急性胰腺炎患者肠道菌群变化及益生菌的应用[J]. 临床肝胆病杂志, 2023, 39 (12): 2970- 2977.
doi: 10.3969/j.issn.1001-5256.2023.12.033 |
| 7 |
Liang Y, Li Y, Lee C, et al. Ulcerative colitis: molecular insights and intervention therapy[J]. Mol Biomed, 2024, 5 (1): 42.
doi: 10.1186/s43556-024-00207-w |
| 8 |
Meng RP, Huang BB, Wei YL, et al. Effectiveness and safety of vedolizumab and infliximab in biologic-naïve patients with moderate-to-severe ulcerative colitis: a multicenter, retrospective cohort study[J]. J Dig Dis, 2024, 25 (4): 230- 237.
doi: 10.1111/1751-2980.13270 |
| 9 |
Kamal ME, Werida RH, Radwan MA, et al. Efficacy and safety of infliximab and adalimumab in inflammatory bowel disease patients[J]. Inflammopharmacology, 2024, 32 (5): 3259- 3269.
doi: 10.1007/s10787-024-01508-w |
| 10 |
Ferrante M, Schirbel A, Pierik MJ, et al. Patient-reported continuous clinical response to golimumab in adults with moderately to severely active ulcerative colitis: results from GO OBSERVE, a real-world European observational study[J]. Eur J Gastroenterol Hepatol, 2022, 34 (6): 646- 654.
doi: 10.1097/MEG.0000000000002374 |
| 11 |
Yan J, Ding X, Wu J, et al. Real-life effectiveness and safety of vedolizumab in moderate-to-severe ulcerative colitis: a single-center experience in Northern China[J]. Medicine, 2024, 103 (27): e38759.
doi: 10.1097/MD.0000000000038759 |
| 12 |
Danese S, Sands BE, Abreu MT, et al. Early symptomatic improvement after ustekinumab therapy in patients with ulcerative colitis: 16-week data from the UNIFI trial[J]. Clin Gastroenterol Hepatol, 2022, 20 (12): 2858- 2867.
doi: 10.1016/j.cgh.2022.02.050 |
| 13 |
Misselwitz B, Juillerat P, Sulz MC, et al. Emerging treatment options in inflammatory bowel disease: Janus kinases, stem cells, and more[J]. Digestion, 2020, 101 (Suppl 1): 69- 82.
doi: 10.1159/000507782 |
| 14 |
Salas A, Hernandez-Rocha C, Duijvestein M, et al. JAK-STAT pathway targeting for the treatment of inflammatory bowel disease[J]. Nat Rev Gastroenterol Hepatol, 2020, 17 (6): 323- 337.
doi: 10.1038/s41575-020-0273-0 |
| 15 |
Harris C, Cummings JRF. JAK1 inhibition and inflammatory bowel disease[J]. Rheumatology, 2021, 60 (Suppl 2): ii45- ii51.
doi: 10.1093/rheumatology/keaa896 |
| 16 |
Banerjee S, Biehl A, Gadina M, et al. JAK-STAT signaling as a target for inflammatory and autoimmune diseases: current and future prospects[J]. Drugs, 2017, 77 (5): 521- 546.
doi: 10.1007/s40265-017-0701-9 |
| 17 |
王欢, 申晓旭, 陈良琪, 等. 肝硬化门静脉高压症患者脾切除后早期血栓形成与Janus激酶-信号转导和转录激活因子信号通路的关系[J]. 临床肝胆病杂志, 2022, 38 (10): 2260- 2264.
doi: 10.3969/j.issn.1001-5256.2022.10.012 |
| 18 |
Mannucci A, D'Amico F, El Saadi A, et al. Filgotinib for moderately to severely active ulcerative colitis[J]. Expert Rev Gastroenterol Hepatol, 2022, 16 (10): 927- 940.
doi: 10.1080/17474124.2022.2138857 |
| 19 |
Xin P, Xu X, Deng C, et al. The role of JAK/STAT signaling pathway and its inhibitors in diseases[J]. Int Immunopharmacol, 2020, 80, 106210.
doi: 10.1016/j.intimp.2020.106210 |
| 20 |
McInnes IB, Byers NL, Higgs RE, et al. Comparison of baricitinib, upadacitinib, and tofacitinib mediated regulation of cytokine signaling in human leukocyte subpopulations[J]. Arthritis Res Ther, 2019, 21 (1): 183.
doi: 10.1186/s13075-019-1964-1 |
| 21 |
Hodge JA, Kawabata TT, Krishnaswami S, et al. The mechanism of action of tofacitinib - an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis[J]. Clin Exp Rheumatol, 2016, 34 (2): 318- 328.
doi: 10.1155/2013/357904 |
| 22 |
Spalinger MR, Sayoc-Becerra A, Ordookhanian C, et al. The JAK inhibitor tofacitinib rescues intestinal barrier defects caused by disrupted epithelial-macrophage interactions[J]. J Crohns Colitis, 2021, 15 (3): 471- 484.
doi: 10.1093/ecco-jcc/jjaa182 |
| 23 | Parra-Izquierdo V, Frías-Ordoñez JS, Márquez JR, et al. Tofacitinib in the treatment of moderate to severe ulcerative colitis in Colombia: real world experience[J]. Gastroenterol Hepatol, 2023, 46 (7): 512- 521. |
| 24 |
Ma C, Panaccione R, Xiao Y, et al. REMIT-UC: real-world effectiveness and safety of tofacitinib for moderate-to-severely active ulcerative colitis: a Canadian IBD research consortium multicenter national cohort study[J]. Am J Gastroenterol, 2023, 118 (5): 861- 871.
doi: 10.14309/ajg.0000000000002129 |
| 25 |
D'Amico F, Magro F, Peyrin-Biroulet L, et al. Positioning filgotinib in the treatment algorithm of moderate to severe ulcerative colitis[J]. J Crohns Colitis, 2022, 16 (5): 835- 844.
doi: 10.1093/ecco-jcc/jjab206 |
| 26 |
Feagan BG, Danese S, Loftus EV, et al. Filgotinib as induction and maintenance therapy for ulcerative colitis (SELECTION): a phase 2b/3 double-blind, randomised, placebo-controlled trial[J]. Lancet, 2021, 397 (10292): 2372- 2384.
doi: 10.1016/S0140-6736(21)00666-8 |
| 27 |
Hibi T, Motoya S, Hisamatsu T, et al. Efficacy and safety of filgotinib as induction and maintenance therapy for Japanese patients with moderately to severely active ulcerative colitis: a post-hoc analysis of the phase 2b/3 SELECTION trial[J]. Intest Res, 2023, 21 (1): 110- 125.
doi: 10.5217/ir.2021.00143 |
| 28 |
Kim JW, Kim SY. The era of Janus kinase inhibitors for inflammatory bowel disease treatment[J]. Int J Mol Sci, 2021, 22 (21): 11322.
doi: 10.3390/ijms222111322 |
| 29 |
Sandborn WJ, Ghosh S, Panes J, et al. Efficacy of upadacitinib in a randomized trial of patients with active ulcerative colitis[J]. Gastroenterology, 2020, 158 (8): 2139- 2149.
doi: 10.1053/j.gastro.2020.02.030 |
| 30 |
Danese S, Vermeire S, Zhou W, et al. Upadacitinib as induction and maintenance therapy for moderately to severely active ulcerative colitis: results from three phase 3, multicentre, double-blind, randomised trials[J]. Lancet, 2022, 399 (10341): 2113- 2128.
doi: 10.1016/S0140-6736(22)00581-5 |
| 31 |
Dalal RS, Kallumkal G, Cabral HJ, et al. Comparative effectiveness of upadacitinib vs ustekinumab for ulcerative colitis: a multicenter retrospective cohort study[J]. Clin Gastroenterol Hepatol, 2024, 22 (3): 666- 668.
doi: 10.1016/j.cgh.2023.08.021 |
| 32 |
Shehab M, Alrashed F, Alsayegh A, et al. Comparative efficacy of biologics and small molecule in ulcerative colitis: systematic review and network meta-analysis[J]. Inflamm Bowel Dis, 2025, 31 (5): 1272- 1280.
doi: 10.1093/ibd/izae163 |
| 33 |
Ananthakrishnan AN, Murad MH, Scott FI, et al. Comparative efficacy of advanced therapies for management of moderate-to-severe ulcerative colitis: 2024 American gastroenterological association evidence synthesis[J]. Gastroenterology, 2024, 167 (7): 1460- 1482.
doi: 10.1053/j.gastro.2024.07.046 |
| 34 |
Strub GM, Paillard M, Liang J, et al. Sphingosine-1-phosphate produced by sphingosine kinase 2 in mitochondria interacts with prohibitin 2 to regulate complex IV assembly and respiration[J]. FASEB J, 2011, 25 (2): 600- 612.
doi: 10.1096/fj.10-167502 |
| 35 | Pettus BJ, Bielawski J, Porcelli AM, et al. The sphingosine kinase 1/sphingosine-1-phosphate pathway mediates COX-2 induction and PGE2 production in response to TNF-alpha[J]. FASEB J, 2003, 17 (11): 1411- 1421. |
| 36 |
Snider AJ, Kawamori T, Bradshaw SG, et al. A role for sphingosine kinase 1 in dextran sulfate sodium-induced colitis[J]. FASEB J, 2009, 23 (1): 143- 152.
doi: 10.1096/fj.08-118109 |
| 37 |
Chen T, Gu K, Lin R, et al. The function of sphingosine-1-phosphate receptor 2 (S1PR2) in maintaining intestinal barrier and inducing ulcerative colitis[J]. Bioengineered, 2022, 13 (5): 13703- 13717.
doi: 10.1080/21655979.2022.2076500 |
| 38 |
Sugahara K, Maeda Y, Shimano K, et al. Amiselimod, a novel sphingosine 1-phosphate receptor-1 modulator, has potent therapeutic efficacy for autoimmune diseases, with low bradycardia risk[J]. Br J Pharmacol, 2017, 174 (1): 15- 27.
doi: 10.1111/bph.13641 |
| 39 | Biswas S, Bryant RV, Travis S. Interfering with leukocyte trafficking in Crohn's disease [J]. Best Pract Res Clin Gastroenterol, 2019, 38-39: 101617. |
| 40 |
Sandborn WJ, Feagan BG, D'Haens G, et al. Ozanimod as induction and maintenance therapy for ulcerative colitis[J]. N Engl J Med, 2021, 385 (14): 1280- 1291.
doi: 10.1056/NEJMoa2033617 |
| 41 |
Cohen NA, Choi D, Garcia N, et al. Real world clinical effectiveness and safety of ozanimod in the treatment of ulcerative colitis: 1-year follow-up from a tertiary center[J]. Dig Dis Sci, 2024, 69 (2): 579- 587.
doi: 10.1007/s10620-023-08178-8 |
| 42 |
Sands BE, Rubin DT, Loftus EV, et al. Impact of prior biologic exposure on ozanimod efficacy and safety in the phase 3 True North Clinical Trial[J]. Am J Gastroenterol, 2025, 120 (10): 2339- 2349.
doi: 10.14309/ajg.0000000000003310 |
| 43 |
Wils P, Peyrin-Biroulet L. Etrasimod for the treatment of ulcerative colitis[J]. Immunotherapy, 2023, 15 (5): 311- 321.
doi: 10.2217/imt-2022-0255 |
| 44 |
Sandborn WJ, Vermeire S, Peyrin-Biroulet L, et al. Etrasimod as induction and maintenance therapy for ulcerative colitis (ELEVATE): two randomised, double-blind, placebo-controlled, phase 3 studies[J]. Lancet, 2023, 401 (10383): 1159- 1171.
doi: 10.1016/S0140-6736(23)00061-2 |
| 45 |
Shirley M. Etrasimod: first approval[J]. Drugs, 2024, 84 (2): 247- 254.
doi: 10.1007/s40265-024-01997-7 |
| 46 |
Sandborn WJ, Peyrin-Biroulet L, Zhang J, et al. Efficacy and safety of etrasimod in a phase 2 randomized trial of patients with ulcerative colitis[J]. Gastroenterology, 2020, 158 (3): 550- 561.
doi: 10.1053/j.gastro.2019.10.035 |
| 47 |
Atreya R, Neurath MF. The sphingosine-1-phosphate receptor agonist etrasimod in ulcerative colitis[J]. Lancet, 2023, 401 (10383): 1132- 1133.
doi: 10.1016/S0140-6736(23)00228-3 |
| 48 |
Al-Jabri R, Afif W. In moderately to severely active UC, etrasimod increased remission at 12 and 52 wk but increased adverse events[J]. Ann Intern Med, 2023, 176 (7): JC82.
doi: 10.7326/j23-0048 |
| 49 |
Matsuoka K, Hibi T. Etrasimod for ulcerative colitis: evaluating phase III results[J]. Nat Rev Gastroenterol Hepatol, 2023, 20 (12): 762- 763.
doi: 10.1038/s41575-023-00793-0 |
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