Biological therapy in IBD. Anti-tumor necrosis factor-alpha and others.

Currently used standard treatment in IBD is effective and sufficient for the majority of patients. Published numbers regarding therapy refractoriness are probably related to referral centers and not representative. Pharmacological optimization of available drugs improves the standard situation further. Biological therapies in a larger meaning are studied intensively, but obviously hopes are to some extent not real. Biological and for some principles clinical effects (i.e. TNF antibodies, CD4 antibodies) are proven, the effects are, however, limited and long-term risks and results are not clarified. Numerous approaches are not clinically relevantly effective which is, in particular, true for those inhibiting single mediators. A number of alternative concepts such as hormones and growth factors could be effective and will be studied further. In particular probiotics may be a development of the future and they belong to the 'biologic treatments' in the true sense. Copyright 2003 S. Karger AG, Basel