Gilead’s emvistegrast posts positive Phase 2 ulcerative colitis results

Gilead’s investigational once-daily oral drug emvistegrast met the primary endpoint in the Phase 2 SWIFT trial in adults with moderately to severely active ulcerative colitis.

At 12 weeks, clinical response was 66% with the 200-mg dose versus 37% with placebo. Clinical remission was 31% versus 8%.

The drug targets α4β7 integrin, a pathway involved in immune-cell movement into gut tissue. Its oral format could offer an alternative to injectable or infused treatments, but it has not been approved and comparisons with existing drugs require larger trials.

Analysts described the results as competitive and supportive of Gilead’s effort to expand beyond HIV into inflammation and immunology. They also noted an uneven dose-response pattern across some secondary measures, and the trial’s size and duration limit conclusions.

Gilead plans to start a Phase 3 monotherapy study in 2027 and is considering combination approaches. SWIFT is ongoing, with maintenance results still needed to assess whether benefits last.