Targeted treatments for UC explained.

If you have moderate to severe ulcerative colitis (UC), your doctor may have mentioned potential treatment options such as targeted oral small molecules or biologics. Here’s an overview of how these treatments work and how they differ from each other. Discuss them with your doctor to learn more about the risks and benefits of these medications to see if they may be an appropriate treatment option for you. Let’s dive in.

You may already know that your immune system uses cells to protect you from viruses, bacteria, and other harmful things. To create and recruit these cells, your immune system uses proteins. In the case of ulcerative colitis, these proteins play a part in creating the inflammation that causes your symptoms.

On this page, you’ll find info about:

Targeted oral small molecules & biologics. What’s the difference?

With ulcerative colitis, people generally produce a large amount of a protein called cytokines. Various cytokines may play a part in causing the inflammation that leads to colon lining damage and symptoms. Both targeted oral small molecule drugs and biologics target cytokines and may reduce their ability to cause inflammation but differ in some ways.

A key difference:

Targeted oral small molecules

are synthetic medications given in pill form.


are genetically engineered proteins that are manufactured or extracted from living organisms in a lab. They are given by injection or infusion.

More about small molecules

Some targeted oral small molecule therapies are taken daily as a pill. And due to their size, they can be transported through the bloodstream to the immune system. These are used to treat patients with moderate to severe ulcerative colitis.

Targeted oral small molecules are taken by mouth

Types of targeted oral small molecules for UC include:

Janus kinase (JAK) inhibitors

JAK inhibitors can interrupt inflammation by blocking the signals of multiple cytokines. They are also targeted which helps control the inflammation in the colon.

Sphingosine-1-phosphate (S1P) receptor modulators

Another oral therapy is S1P receptor modulators, which work by targeting lymphocytes, a type of white blood cell in the immune system.

More about biologics

Biologics are injections or infusions

They can be administered weekly or every few months, depending on the individual and the medication. Biologics target specific proteins and attach to them, helping to stop their ability to cause inflammation.

Here are a few kinds of biologics:

Anti-Tumor Necrosis Factor (Anti-TNF) Agents

These biologics work by binding and blocking a small protein called tumor necrosis factor alpha (TNF-alpha) that reduces inflammation in the intestine, as well as other organs and tissues.

Integrin Receptor Antagonists

These biologics can stop certain cells from moving out of blood vessels and into the tissues by blocking a protein on the surface of the cells themselves. Typically, they’re used on patients who didn’t get relief from other treatments or found them hard to tolerate.

Interleukin (IL)-12 and IL-23 Antagonists

IL-12 and IL-23 are proteins that can increase inflammation. It’s thought that people with UC have higher levels of IL-12 and IL-23 in their GI tract. These biologics can target these excess proteins.

Is a biologic or targeted oral small molecule right for me?

Biologics and targeted oral small molecules are prescription medicines for people with moderate to severe UC. Biologics can be used for people who have tried other treatments first or for people who have not tried other treatments. Targeted oral small molecules are used for people in whom certain other treatments didn’t work well. That’s why you should have an open conversation with a gastroenterologist to learn more about the risks and benefits of these medications to see if they may be an appropriate treatment option for you.

Interested in a treatment option?

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To find a treatment plan that may be right for you, Team Up with a Gastroenterologist


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