[Biological therapies for treatment of chronic inflammatory bowel diseases. Status update].
BACKGROUND
For the treatment of inflammatory bowel diseases in recent years several antibodies, cytokines and antisense oligonucleotides have been developed using recombinant technology and were tested as so-called "biological therapeutics".
Infliximab, a chimeric TNF-alpha antibody, is the only biological remedy approved for the treatment of refractory and fistulizing Crohn's disease. Because of inherent risks for severe side effects, such as sepsis, the indication should be restricted to truly refractory patients and treated patients must be followed very carefully. In clinical trials other anti-TNF-alpha-effective substances (CDP 571, etanercept, thalidomide), interleukin-10, interleukin-11, ICAM-1-antisense-oligonucleotides and antibodies against alpha 4-integrin were evaluated for the treatment of Crohn's disease. In summary, for all a slight effect was noted but their place in the therapeutical repertoire is not yet defined. None of these substances is approved for patients with inflammatory bowel disease. Future developments are eagerly awaited.
Metzler
Jörg
J
Zentrum für Innere Medizin 1, Robert-Bosch-Krankenhaus, Stuttgart. joerg.metzler@rbk.de
Stange
Eduard F
EF
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003093:Colitis, Ulcerative / Q000276:immunology / Q000628:therapy*; D003424:Crohn Disease / Q000276:immunology / Q000628:therapy*; D006801:Humans; D000069285:Infliximab; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000502:physiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab