Dr Berinstein recaps his 'pitch' for the use of JAK inhibitors with corticosteroids to control acute severe ulcerative colitis, which he made to the "Shark Tank" panel at the Crohn's & Colitis Congress.

Jeffrey Berinstein MD, MSc, is a clinical lecturer and a member of the Inflammatory Bowel Disease Program at the University of Michigan.

TRANSCRIPT:

I'm Jeffrey Berinstein from the University of Michigan and I presented in this year's Crohn's and Colitis Congress Shark Tank on using upfront JAK inhibitor therapy with IV corticosteroids for patients with acute severe ulcerative colitis who previously failed an anti-TNF. My job and my pitch was to convince the judge that using JAK inhibitors upfront, along with IV corticosteroids, was the way to improve outcomes for acute severe ulcerative colitis. For those of you who don't know, acute severe ulcerative colitis is a very serious condition. If you don't intervene early with effective therapy, patients can rapidly deteriorate and experience complications, colectomy, and even mortality.

We do have some therapies, like steroids and cyclosporine and infliximab, but there are issues with these therapies, including patients having been on them before and failed them and also having numerous complications with some of them. That's why, for the patients who have already failed anti-TNFs before, we thought JAKs would be perfect for 4 reasons, and those being that JAK inhibitors are effective, JAK inhibitors are fast, JAK inhibitors are safe, and JAK inhibitors have predictable oral pharmacokinetics. These 4 reasons made JAK inhibitors like upadacitinib and tofacitinib very attractive. I was able to present some of our data from the University of Michigan that basically showed patients were able to avoid colectomy in a significant amount of cases because of the use of JAK inhibitors but, more importantly, by using them upfront on admission rather than waiting 3 to 4 days when the patient was outside of their treatment.

Fortunately, the panel liked my pitch. They were excited about my reasoning and my presentation and they offered to give me $10 million for a hypothetical trial. It was a fun exercise and I think the panel enjoyed it, I think the participants enjoyed it, and I had a lot of fun.