Marianne Vulliemoz1, Stephan Brand2, Pascal Juillerat3, Christian Mottet4,5, Shomron Ben-Horin6, Pierre Michetti4. 1. Crohn's and Colitis Center, Gastroenterologie Beaulieu and Division of Gastroenterology and Hepatology, CHUV, Lausanne, Switzerland, mvulliemoz@gesb.ch. 2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kantonsspital Sankt Gallen, St. Gallen, Switzerland. 3. Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland. 4. Crohn's and Colitis Center, Gastroenterologie Beaulieu and Division of Gastroenterology and Hepatology, CHUV, Lausanne, Switzerland. 5. Centre sédunois de Gastroentérologie, Sion, Switzerland. 6. Inflammatory Bowel Disease Unit and Gastro-Immunology Laboratory Sheba Medical Center Tel-Aviv University, Tel-Aviv, Israel.
Abstract
BACKGROUND: Anti-tumour necrosis factor-alpha (anti-TNF) antagonists have been the mainstay in the treatment of inflammatory bowel diseases (IBDs) for over 20 years. SUMMARY: This review article aimed to provide an update on recent advances in TNF antagonist therapy for IBDs. Key Messages: Their position in the treatment algorithm has evolved to "rapid step-up therapy" or "top-down therapy" according to disease severity and patients' characteristics. Limitations of anti-TNF antagonists include loss of response in up to 30-50% of patients with or without the development of antibodies. Therapeutic drug monitoring should provide a tailored, personalized approach to this scenario. Recently, biosimilar agents have been approved for IBDs and are considered equivalent in efficacy to the originator.
BACKGROUND: Anti-tumour necrosis factor-alpha (anti-TNF) antagonists have been the mainstay in the treatment of inflammatory bowel diseases (IBDs) for over 20 years. SUMMARY: This review article aimed to provide an update on recent advances in TNF antagonist therapy for IBDs. Key Messages: Their position in the treatment algorithm has evolved to "rapid step-up therapy" or "top-down therapy" according to disease severity and patients' characteristics. Limitations of anti-TNF antagonists include loss of response in up to 30-50% of patients with or without the development of antibodies. Therapeutic drug monitoring should provide a tailored, personalized approach to this scenario. Recently, biosimilar agents have been approved for IBDs and are considered equivalent in efficacy to the originator.
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