Managing Risks with Newer Oral Small Molecules in Patients with Inflammatory Bowel Diseases

Malek Ayoub, Shivani Mattay, Andres J. Yarur, Parakkal Deepak

Research output: Contribution to journalArticlepeer-review


Purpose of Review: Treatment of Inflammatory Bowel Diseases (IBD) is challenging; thus, the need for newer therapeutic options with an oral route of administration has led to the development of novel small molecules drugs (SMDs). We aim to highlight the most common Adverse events (AEs) associated with SMDs and recommendations on monitoring for AEs before and during treatment. Recent Findings: SMDs, such as Tofacitinib, a JAK inhibitor, have been associated with laboratory abnormalities, infections, and risk of thromboembolic events. Therefore, oral agents with greater selectivity in JAK inhibition, such as tofacitinib and upadacitinib, were later developed. Ozanimod and etrasimod, S1PR agonists, require closer safety profile monitoring by clinicians. Summary: Multiple therapies have been recently developed with variable efficacy. However, they have been associated with AEs, and some require close monitoring prior to and during therapy. Clinicians should highlight these adverse events to patients while reassuring the safety profile of these novel SMDs for IBD is favorable.

Original languageEnglish
JournalCurrent gastroenterology reports
StateAccepted/In press - 2024


  • Adverse events
  • Inflammatory Bowel Disease
  • Janus Kinase inhibitors
  • Major adverse cardiovascular events
  • Small molecules
  • Sphingosine-1-phosphate agonists


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