Emerging biological treatments in inflammatory bowel diseases.
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| Abstract |
Although the advent of infliximab has changed the treatment paradigm and goals in inflammatory bowel disease, it does not provide a cure for it and recent evidence has demonstrated that the immunogenicity of this chimeric anti-tumor necrosis factor antibody is associated with secondary loss of response and intolerance. In ulcerative colitis the efficacy of infliximab was demonstrated in two large clinical trials, but long-term maintenance efficacy data are lacking. Novel biological agents have entered clinical development and pioneering trials have been reported in the last 2 years. For Crohn's disease the fully human IgG1 anti-tumor necrosis factor monoclonal adalimumab, and the humanized anti-alpha4-integrin IgG4 antibody, natalizumab have yielded the most promising results in controlled trials, but also agents inhibiting the crucial interleukin-12/interferon-gamma feedback loop suggest therapeutic potential. For severe ulcerative colitis infliximab has been shown to be an effective rescue treatment and the anti-T-cell CD3 antibody has shown promising open-label results. Crucial in the development of novel biological agents, however, is the benefit:risk ratio. As illustrated by unexpected but devastating brain infections with anti-adhesion molecules, clinicians should be aware that the powerful immunomodulatory capacity of biologicals necessitates a rigorous safety follow-up.
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| Authors | Gert Van Assche, Séverine Vermeire, Paul Rutgeerts |
| Journal | Digestive diseases (Basel, Switzerland) (Dig Dis) Vol. 24 Issue 1-2 Pg. 131-6 ( 2006) ISSN: 0257-2753 [Print] Switzerland |
| PMID | 16699271 (Publication Type: Journal Article, Review) |
| Copyright | Copyright 2006 S. Karger AG, Basel. |
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