Anti-adhesion molecules: is gut specificity the key for a good safety profile?

Inflammatory bowel diseases (IBD) are chronic relapsing and remitting disorders that have varying degrees of severity. However multiple studies have confirmed that a large proportion of patients on maintenance treatment lose response to anti-TNF therapy. This has led to increasing interest in the concept of 'switching therapy out-of-class' i.e. a nonanti- TNF antibody when patients either fail to respond (primary non-response, develop secondary non-response) or do not tolerate anti-TNF therapies. The most widely known and studied alternative class of antibodies therapies at present are the selective adhesion molecule inhibitors. Several antibodies exist which constitute selection adhesion molecule inhibitors, including Natalizumab, MLN-0002 (Vedolizumab) and ISIS 2302 (Alicaforsen) will be discussed in this review.