Review article
PLACE OF BIOLOGIC THERAPY IN THE TREATMENT OF INFLAMMATORY BOWEL DISEASES AND ASSESSMENT OF ITS EFFICACY
ŽELJKO KRZNARIĆ
; University of Zagreb Medical School, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Clinical Hospital Center and Nutritional Unit, Department of Medicine, Clinical Hospital Center Zagreb, Zagreb, Croatia
DAVOR ŠTIMAC
; Division of Gastroenterology, Department of Internal Medicine, Clinical Hospital Center Rijeka, University of Rijeka Medical School, Rijeka, Croatia
NEVEN FRANJIĆ
; Division of Gastroenterology, Department of Internal Medicine, Clinical Hospital Center Rijeka, University of Rijeka Medical School, Rijeka, Croatia
ANA KUNOVIĆ
; Nutritional Unit, Department of Medicine, Clinical Hospital Center Zagreb, Zagreb, Croatia
DINA LJUBAS KELEČIĆ
; Nutritional Unit, Department of Medicine, Clinical Hospital Center Zagreb, Zagreb, Croatia
Abstract
Biological therapy (infliximab and adalimumab) in inflammatory bowel diseases is based on the IgG1 anti-TNF monoclonal antibodies with potent anti-inflammatory effects whose main mechanism of action is thought to be the induction of inflammatory cell apoptosis. Unquestionably, which arises from the most recent studies and meta-analysis, anti-TNF angents are an effective therapy primarily for the treatment of Crohn’s disease, but also ulcerative colitis, in different clinical situations. Infliximab has the most extensive clinical trial data, but other biological agents, such as adalimumab and certolizumab pegol appear to have similar benefits. In terms of future research, more long-term data are needed for both certolizumab pegol in Crohn’s disease and adalimumab in ulcerative colitis. Important role in the application of biological therapy is assessing its effectiveness and cost-benefit relationships that are estimated by regular follow-up. In the absence of response (primary and secondary) therapeutical options are dose increase, giving the drug in shorter intervals and substitution with other biological drug.
Keywords
inflammatory bowel disease; Crohn’s disease; ulcerative colitis; biological therapy; infliximab; adalimumab; certolizumab pegol
Hrčak ID:
111688
URI
Publication date:
28.11.2013.
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