PURPOSE OF REVIEW: The inflammatory bowel diseases (IBDs) are chronic disabling conditions. Despite the benefits of anti-tumor necrosis factor (TNF)-α agents in improving quality of life and reducing the need for surgeries, overall only one-third of patients are in clinical remission at 1 year and loss of response is frequent. It seems clear that treatment must go beyond alleviation of symptoms in IBD. It is important that treatment targets in IBD will ensure mucosal healing and deep remission. RECENT FINDINGS: The induction of deep remission might be the best way to alter the natural course of these diseases by preventing disability and bowel damage. New disability indices and the new Crohn's disease damage score have recently been developed and they can be used to evaluate the long-term effect on patients and as new endpoints in trials. Early intervention with disease-modifying anti-IBD drugs (DMAIDs) should be considered in patients with poor prognostic factors. SUMMARY: New therapeutic targets in IBD patients who failed anti-TNF-α therapy are urgently required, and tofacitinib, vedolizumab and ustekinumab appear to be the most promising drugs. Herein, we review the new and current trends in IBD therapy, with the final aim of changing disease course and patients' lives by both improving quality of life and avoiding disability.
PURPOSE OF REVIEW: The inflammatory bowel diseases (IBDs) are chronic disabling conditions. Despite the benefits of anti-tumornecrosis factor (TNF)-α agents in improving quality of life and reducing the need for surgeries, overall only one-third of patients are in clinical remission at 1 year and loss of response is frequent. It seems clear that treatment must go beyond alleviation of symptoms in IBD. It is important that treatment targets in IBD will ensure mucosal healing and deep remission. RECENT FINDINGS: The induction of deep remission might be the best way to alter the natural course of these diseases by preventing disability and bowel damage. New disability indices and the new Crohn's disease damage score have recently been developed and they can be used to evaluate the long-term effect on patients and as new endpoints in trials. Early intervention with disease-modifying anti-IBD drugs (DMAIDs) should be considered in patients with poor prognostic factors. SUMMARY: New therapeutic targets in IBD patients who failed anti-TNF-α therapy are urgently required, and tofacitinib, vedolizumab and ustekinumab appear to be the most promising drugs. Herein, we review the new and current trends in IBD therapy, with the final aim of changing disease course and patients' lives by both improving quality of life and avoiding disability.
Authors: Gottfried Novacek; Hans Peter Gröchenig; Thomas Haas; Heimo Wenzl; Pius Steiner; Robert Koch; Thomas Feichtenschlager; Gerald Eckhardt; Andreas Mayer; Andreas Kirchgatterer; Othmar Ludwiczek; Reingard Platzer; Pavol Papay; Johanna Gartner; Harry Fuchssteiner; Wolfgang Miehsler; Paul-Gerhard Peters; Gerhard Reicht; Harald Vogelsang; Clemens Dejaco; Thomas Waldhör Journal: Wien Klin Wochenschr Date: 2019-02-04 Impact factor: 1.704
Authors: Steven F G Jeuring; Tim R A van den Heuvel; Limmie Y L Liu; Maurice P Zeegers; Wim H Hameeteman; Mariëlle J L Romberg-Camps; Liekele E Oostenbrug; Ad A M Masclee; Daisy M A E Jonkers; Marieke J Pierik Journal: Am J Gastroenterol Date: 2016-12-06 Impact factor: 10.864
Authors: K T Park; Wallace V Crandall; Jacqueline Fridge; Ian H Leibowitz; Marc Tsou; Dana M H Dykes; Edward J Hoffenberg; Michael D Kappelman; Richard B Colletti Journal: Inflamm Bowel Dis Date: 2014-05 Impact factor: 5.325
Authors: Laurent Peyrin-Biroulet; W Scott Harmsen; William J Tremaine; Alan R Zinsmeister; William J Sandborn; Edward V Loftus Journal: Clin Gastroenterol Hepatol Date: 2016-05-04 Impact factor: 11.382