Drugs of today
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The causes of inflammatory bowel diseases, such as ulcerative colitis (UC) and Crohn's disease (CD), remain to be elucidated. However, characteristic inflammation of the gastrointestinal mucosa is caused by infiltration of T lymphocytes into the submucosal layer. Inhibiting this immune response is a promising therapeutic target. ⋯ Regulatory applications are under review in the U. S. and E. U. for its use in the treatment of patients with UC and CD, with decisions expected in mid-2014.
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Ibrutinib is a novel oral tyrosine kinase inhibitor that irreversibly binds and inhibits tyrosine-protein kinase BTK (Bruton tyrosine kinase). BTK has been found to be important in the function of B-cell receptor signaling and therefore in the maintenance and expansion of various B-cell malignancies including chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL). Targeting BTK with ibrutinib has been found to be an effective strategy in treating these malignancies. ⋯ S. Food and Drug Administration granted accelerated approval for ibrutinib in November 2013 for patients with MCL who had received at least one prior therapy and in February 2014 for patients with CLL who had received at least one prior therapy. This review will discuss the preclinical pharmacology, pharmacokinetics and clinical efficacy to date of ibrutinib in the treatment of CLL and MCL.