BACKGROUND: Until recently, the management of ulcerative colitis (UC) consisted of the stepwise use of mesalazine, corticosteroids and immunomodulators, or consideration of surgery. Anti-tumour necrosis factor (TNF) agents are recent additions to the UC-treatment algorithm. AIM: To provide clinicians with a review of the role of anti-TNFs in UC, discussing how the drug(s) were used in the past, their current use and to determine their future role. METHODS: The scientific literature was reviewed to evaluate data on the use of anti-TNFs in UC. RESULTS: In this review, we report how the management of UC has changed with the availability of anti-TNFs. The results from landmark anti-TNF trials have impacted clinical practice, leading to a readjustment of treatment goals. In addition, experience from clinical trials and local real-life cohorts have helped to clarify some misunderstandings in the management of UC. New anti-TNFs are on the horizon but questions still remain on the future role of anti-TNFs with regard to impact on disability, digestive damage and the possible development of risk matrices. Experiences from the use of anti-TNFs in Crohn's disease (for example, combination therapy and early treatment) now need to be addressed in UC. CONCLUSIONS: The use of anti-TNFs in the management of UC has matured rapidly. Clinical experience has helped shape the current role of anti-TNFs, but more clinical research is needed to optimise their future role.
BACKGROUND: Until recently, the management of ulcerative colitis (UC) consisted of the stepwise use of mesalazine, corticosteroids and immunomodulators, or consideration of surgery. Anti-tumour necrosis factor (TNF) agents are recent additions to the UC-treatment algorithm. AIM: To provide clinicians with a review of the role of anti-TNFs in UC, discussing how the drug(s) were used in the past, their current use and to determine their future role. METHODS: The scientific literature was reviewed to evaluate data on the use of anti-TNFs in UC. RESULTS: In this review, we report how the management of UC has changed with the availability of anti-TNFs. The results from landmark anti-TNF trials have impacted clinical practice, leading to a readjustment of treatment goals. In addition, experience from clinical trials and local real-life cohorts have helped to clarify some misunderstandings in the management of UC. New anti-TNFs are on the horizon but questions still remain on the future role of anti-TNFs with regard to impact on disability, digestive damage and the possible development of risk matrices. Experiences from the use of anti-TNFs in Crohn's disease (for example, combination therapy and early treatment) now need to be addressed in UC. CONCLUSIONS: The use of anti-TNFs in the management of UC has matured rapidly. Clinical experience has helped shape the current role of anti-TNFs, but more clinical research is needed to optimise their future role.
Authors: Brendan Halloran; Jessica Chang; David Q Shih; Dermot McGovern; Konrad Famulski; Chad Evaschesen; Richard N Fedorak; Aducio Thiesen; Stephan Targan; Philip F Halloran Journal: Inflamm Bowel Dis Date: 2014-12 Impact factor: 5.325
Authors: Fanni Rencz; Márta Péntek; Martin Bortlik; Edyta Zagorowicz; Tibor Hlavaty; Andrzej Śliwczyński; Mihai M Diculescu; Limas Kupcinskas; Krisztina B Gecse; László Gulácsi; Peter L Lakatos Journal: World J Gastroenterol Date: 2015-02-14 Impact factor: 5.742
Authors: Iris Detrez; Erwin Dreesen; Thomas Van Stappen; Annick de Vries; Els Brouwers; Gert Van Assche; Séverine Vermeire; Marc Ferrante; Ann Gils Journal: J Crohns Colitis Date: 2016-01-06 Impact factor: 9.071