Where ulcerative colitis treatment is heading

Ulcerative colitis is a lifelong inflammatory disease of the colon causing diarrhea, bleeding and abdominal pain; about 20,000 to 30,000 Americans are newly diagnosed each year, most before age 35. A wave of new biologics and pills (IL-23 blockers, S1P modulators, JAK inhibitors) has expanded options well beyond the older anti-TNF drugs, and a blood test may soon help pick the right one.

• 455studies open or running
• 44phase 3 trials
• 4,380papers published this year
• 40NIH-funded projects

1. Now

   Nov 2026

   Two new IL-23 drugs approvedHappened 23% in remission

   Guselkumab and risankizumab both roughly tripled remission rates over placebo.

   23%: in remission at 12 weeks, vs 8% with placebo.

   • QUASAR trial
   • Risankizumab trials

   A blood test to predict who respondsHappened 26% in remission

   Tulisokibart worked far better in people whose blood test predicted a response (32% vs 11%).

   26%: in remission with tulisokibart, vs 1% with placebo.

   • Tulisokibart trial

   A new daily pill nears approvalHappened 51% in remission at 44 wks

   Obefazimod kept about half of responders in remission at 44 weeks vs 10% with placebo.

   51%: in remission at 44 weeks, vs 10% with placebo.

   • ABTECT maintenance trial

2. 6 months

   by May 2027

   Tulisokibart's phase 3 trial maturesLikely 26% in remission

   Merck's 1,109-person phase 3 trial, using the same predictive blood test, finishes August 2026.

   26%: in remission with tulisokibart, vs 1% with placebo.

   • Tulisokibart trial

3. 12 months

   by Nov 2027

   Obefazimod's FDA filingLikely

   A new drug application is planned by the end of 2026, following agreement with the FDA on its submission plan.

   • ABTECT maintenance trial

4. 3 years

   by late 2029

   A pill that blocks a new cell-signaling targetPossible

   Janssen's icotrokinra (896 people) is in phase 3; due January 2028.

   • ICONIC-UC

   Treating UC and obesity togetherLong shot

   Eli Lilly's COMMIT-UC tests mirikizumab alongside tirzepatide (a weight-loss drug) for people with both conditions; due April 2028.

   • COMMIT-UC

5. 5 years

   by late 2031

   A new antibody and a new combination deviceLong shot

   Roche's afimkibart (TL1A-targeted) and Janssen's two-drug combination JNJ-78934804 are both in phase 3; due 2027-2028.

   • Ametrine-1
   • DUET ENCORE-UC

The research paths

Borrowed from other conditions

Open to join now

• Moderate to severe UC

  JNJ-78934804

  Phase 3 · 318 sites

  Locations and eligibility →

• UC with obesity

  Mirikizumab with tirzepatide

  Phase 3 · 186 sites

  Locations and eligibility →

• Moderate to severe UC

  Duvakitug induction (SUNSCAPE-1)

  Phase 3 · 240 sites

  Locations and eligibility →

See every recruiting Ulcerative colitis trial →

When the trials finish

Completion dates the trials registered. Results usually follow 3 to 12 months later.

What just happened

Standard treatment today

• Mild5-ASA pills or enemas.
• Moderate to severeBiologics (anti-TNF, vedolizumab, ustekinumab, guselkumab, risankizumab) or pills (tofacitinib, upadacitinib, etrasimod).
• Not respondingSwitch drug class; combination therapy in trials; surgery (colectomy) for severe or uncontrolled disease.
• Severe flare (hospitalized)IV steroids, then infliximab or cyclosporine if steroids fail.

See Ulcerative colitis trials recruiting now →