Header

UZH-Logo

Maintenance Infos

Use of biological molecules in the treatment of inflammatory bowel disease


Nielsen, O H; Seidelin, J B; Munck, L K; Rogler, G (2011). Use of biological molecules in the treatment of inflammatory bowel disease. Journal of Internal Medicine, 270(1):15-28.

Abstract

Abstract.  Nielsen OH, Seidelin JB, Munck LK, Rogler G (Herlev Hospital, University of Copenhagen, Copenhagen; Køge Hospital, University of Copenhagen, Copenhagen, Denmark; and University Hospital of Zürich, Zürich, Switzerland) Use of biological molecules in the treatment of inflammatory bowel disease (Review). J Intern Med 2011; doi: 10.1111/j.1365-2796.2011.02344.x. The introduction of biological agents (i.e. antitumour necrosis factor-α and anti-integrin treatments) for the treatment of inflammatory bowel disease (IBD) [i.e. Crohn's disease (CD) and ulcerative colitis] has led to a substantial change in the treatment algorithms and guidelines, especially in CD. However, many questions still remain about the true efficacy and the best treatment regimens. Thus, a need for further treatment options still exists as up to 40% of IBD patients treated with the presently available biologicals do not have positive clinical responses. Better patient selection might maximize the clinical benefit for those in most need of an effective therapy to avoid disabling disease whilst also minimizing the complications associated with therapy. Further, the 'trough-level strategy' may help clinicians to optimize therapy and to avoid loss of response and/or immunogenicity. The idea behind this dosage regimen is that correct dosing must ensure that the patient's lowest level of drug concentration (i.e. the trough level) occurring just before the next drug administration is high enough for the full effect to be seen. Controversy continues regarding the appropriate use of biologicals; therefore, in this review, we focus on considerations that might lead to a more rational strategy for antitumour necrosis factor-α agents in IBD, emphasizing the situations in which the risks may outweigh the benefits. Finally, the need for an appropriate strategy for stopping biological treatment is discussed.

Abstract

Abstract.  Nielsen OH, Seidelin JB, Munck LK, Rogler G (Herlev Hospital, University of Copenhagen, Copenhagen; Køge Hospital, University of Copenhagen, Copenhagen, Denmark; and University Hospital of Zürich, Zürich, Switzerland) Use of biological molecules in the treatment of inflammatory bowel disease (Review). J Intern Med 2011; doi: 10.1111/j.1365-2796.2011.02344.x. The introduction of biological agents (i.e. antitumour necrosis factor-α and anti-integrin treatments) for the treatment of inflammatory bowel disease (IBD) [i.e. Crohn's disease (CD) and ulcerative colitis] has led to a substantial change in the treatment algorithms and guidelines, especially in CD. However, many questions still remain about the true efficacy and the best treatment regimens. Thus, a need for further treatment options still exists as up to 40% of IBD patients treated with the presently available biologicals do not have positive clinical responses. Better patient selection might maximize the clinical benefit for those in most need of an effective therapy to avoid disabling disease whilst also minimizing the complications associated with therapy. Further, the 'trough-level strategy' may help clinicians to optimize therapy and to avoid loss of response and/or immunogenicity. The idea behind this dosage regimen is that correct dosing must ensure that the patient's lowest level of drug concentration (i.e. the trough level) occurring just before the next drug administration is high enough for the full effect to be seen. Controversy continues regarding the appropriate use of biologicals; therefore, in this review, we focus on considerations that might lead to a more rational strategy for antitumour necrosis factor-α agents in IBD, emphasizing the situations in which the risks may outweigh the benefits. Finally, the need for an appropriate strategy for stopping biological treatment is discussed.

Statistics

Citations

19 citations in Web of Science®
25 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

0 downloads since deposited on 03 Mar 2011
0 downloads since 12 months

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gastroenterology and Hepatology
Dewey Decimal Classification:610 Medicine & health
Date:2011
Deposited On:03 Mar 2011 16:53
Last Modified:07 Dec 2017 07:56
Publisher:Wiley-Blackwell
ISSN:0954-6820
Publisher DOI:https://doi.org/10.1111/j.1365-2796.2011.02344.x
PubMed ID:21241384

Download