BACKGROUND: There is a great unmet clinical need for efficacious, tolerable, 
economical and orally administrated drugs for the treatment of inflammatory 
bowel disease (IBD). New therapeutic avenues have become possible including the 
development of medications that target specific genetic pathways found to be 
relevant in other immune mediated diseases.
AIMS: To provide an overview of recent clinical trials for new generation oral 
targeted medications that may have a future role in IBD management.
METHODS: Pubmed and Medline searches were performed up to 1 March 2018 using 
keywords: "IBD", "UC", "CD", "inflammatory bowel disease" "ulcerative colitis", 
"Crohn's disease" in combination with "phase", "study", "trial" and "oral". A 
manual search of the clinical trial register, article reference lists, abstracts 
from meetings of Digestive Disease Week, United European Gastroenterology Week 
and ECCO congress were also conducted.
RESULTS: In randomised controlled trials primary efficacy endpoints were met for 
tofacitinib (JAK 1/3 inhibitor-phase III), upadacitinib (JAK 1 inhibitor-phase 
II) and AJM300 (α4-integrin antagonist-phase II) in ulcerative colitis. Ozanimod 
(S1P receptor agonist-phase II) also demonstrated clinical remission. For 
Crohn's disease, filgotinib (JAK1 inhibitor-phase II) met primary endpoints and 
laquinimod (quinolone-3-carboxide small molecule-phase II) was also efficacious. 
Trials using mongersen (SMAD7 inhibitor) and vidofludimus (dihydroorotate 
dehydrogenase inhibitor) have been halted.
CONCLUSIONS: This is potentially the start of an exciting new era in which 
multiple therapeutic options are at the disposal of physicians to treat IBD on 
an individualised basis. Head-to-head studies with existing treatments and 
longer term safety data are needed for this to be possible.