dc.description.abstract |
The past decade has brought substantial advances in the management of inflammatory bowel diseases (IBD). The introduction of tumor necrosis factor (TNF) antagonists, evidence for the value of combination therapy, the recognition of targeting lymphocyte trafficking and activation as a viable treatment, and the need for early treatment of high-risk patients are all fundamental concepts for current modern IBD treatment algorithms. In this article, authors review the existing data on approved biologicals and small molecules as well as provide insight on the current positioning of approved therapies. Patient stratification for the selection of specific therapies, therapeutic targets and patient monitoring will be discussed as well. The therapeutic armamentarium for IBD is expanding as novel and more targeted therapies become available. In the absence of comparative trials, positioning these agents is becoming difficult. Emerging concepts for the future will include an emphasis on the development of algorithms which will facilitate a greater understanding of the positioning of novel biological drugs and small molecules in order to best tailor therapy to the patient. In the interim, anti-TNF therapy remains an important component of IBD therapy with the most real-life evidence and should be considered as first-line therapy in patients with complicated Crohn's disease and in acute-severe ulcerative colitis. The safety and efficacy of these 'older' anti-TNF therapies can be optimized by adhering to therapeutic algorithms which combine clinical and objective markers of disease severity and response to therapy. |
|
dc.mtmt.swordnote |
Funding Agency and Grant Number: AbbVieAbbott Laboratories; JanssenJohnson & Johnson USAJanssen Biotech Inc; Pentax; Echosense; MSD; PfizerPfizer
Funding text: Bessissow T has been a speaker and/or advisory board member for: AbbVie, Janssen, Takeda, Pfizer, Merck, Shire, Ferring and Pendopharm and has received unrestricted research grant from: AbbVie, Janssen, Pentax and Echosense; Lakatos PL has been a speaker and/or advisory board member: AbbVie, Celltrion, Falk Pharma GmbH, Ferring, Genetech, Jansen, Kyowa Hakko Kirin Pharma, Mitsubishi Tanabe Pharma Corporation, MSD, Otsuka Pharma, Pharmacosmos, Pfizer, Roche, Shire and Takeda and has received unrestricted research grant: AbbVie, MSD and Pfizer. There are no conflicts of interest to report from other authors
Department of Gastroenterology, McGill University Health Center, Montreal, QC H4A 3J1, Canada
First Department of Medicine, Semmelweis University, Koranyi S. 2A, Budapest, H-1083, Hungary
Cited By :15
Export Date: 1 October 2020
CODEN: WJGAF
Correspondence Address: Lakatos, P.L.; First Department of Medicine, Semmelweis University, Koranyi S. 2A, Hungary; email: kislakpet99@gmail.com
Chemicals/CAS: adalimumab, 331731-18-1, 1446410-95-2; certolizumab pegol, 428863-50-7; golimumab, 476181-74-5; infliximab, 170277-31-3; natalizumab, 189261-10-7; tofacitinib, 477600-75-2, 540737-29-9; ustekinumab, 815610-63-0, 949907-93-1; vedolizumab, 943609-66-3; Biological Factors; Tumor Necrosis Factor-alpha
Department of Gastroenterology, McGill University Health Center, Montreal, QC H4A 3J1, Canada |
|