The role of biologics in the treatment of patients with inflammatory bowel disease

Br J Hosp Med (Lond). 2018 Dec 2;79(12):686-693. doi: 10.12968/hmed.2018.79.12.686.

Abstract

The treatment of inflammatory bowel disease has changed dramatically over the last two decades. The arrival of infliximab as the first biological medicine for inflammatory bowel disease revolutionized its management. Since then the armamentarium of biological medicines for inflammatory bowel disease has grown to five drugs in three different classes. This article highlights the different mechanisms of action and describes the key evidence for their use including drug safety profiles. Furthermore it highlights the current National Institute for Health and Care Excellence recommendations for biological therapy in inflammatory bowel disease and discusses pending changes to the classic treatment algorithms in light of emerging evidence.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Biological Products / adverse effects
  • Biological Products / pharmacology
  • Biological Products / therapeutic use*
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / physiopathology
  • Crohn Disease / drug therapy
  • Crohn Disease / physiopathology
  • Drug Monitoring / methods
  • Gastrointestinal Agents / adverse effects
  • Gastrointestinal Agents / pharmacology
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / physiopathology
  • Infliximab / pharmacology
  • Infliximab / therapeutic use
  • Severity of Illness Index
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Ustekinumab / pharmacology
  • Ustekinumab / therapeutic use

Substances

  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • Gastrointestinal Agents
  • Tumor Necrosis Factor-alpha
  • vedolizumab
  • Infliximab
  • Ustekinumab