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Presently, the only effective treatment is adoption of a gluten\u2010free diet (GFD), although strict adherence is challenging to maintain, and inadvertent gluten exposures are inevitable for most patients. Hence, there is substantial interest in drug development in CeD and multiple novel therapies are under investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To review existing and upcoming clinical trial programmes for pharmacologic agents for CeD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A narrative review was performed, informed by a search of MEDLINE, Embase, the Cochrane CENTRAL Library and <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We summarise the pathophysiology of CeD and the specific steps that are potentially amenable to pharmacologic treatment. We evaluate the evidence supporting existing and future drug targets, including trials of peptidases, gluten sequestrants, tight junction regulators, anti\u2010transglutaminase 2 therapies, immune tolerizing agents, advanced biologics and small molecules, and microbiome\u2010targeted strategies. We highlight unique considerations for conducting CeD trials, including identifying appropriate study populations, assessing results in the context of a gluten challenge, and interpreting CeD\u2010specific clinical and histologic outcomes. Understanding these factors is crucial for accurately appraising the evidence. Finally, we outline what the future of CeD therapy may hold with the introduction of pharmacotherapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a need for pharmacologic options for CeD, either used adjunctively with a GFD for accidental or intentional gluten exposures or for refractory disease. Multiple promising agents are in development, and these trials are likely to lead to approvals for the first generation of pharmacologic agents for CeD within the next 5\u00a0years.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16846","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T04:48:16Z","timestamp":1646110096000},"page":"1277-1296","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Review article: therapeutic targets for the pharmacologic management of coeliac disease\u2014the future beyond a gluten\u2010free diet"],"prefix":"10.1111","volume":"55","author":[{"given":"Michael","family":"Klonarakis","sequence":"first","affiliation":[{"name":"Department of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher N.","family":"Andrews","sequence":"additional","affiliation":[{"name":"Division of 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