New therapeutic approach in inflammatory bowel disease.
In the last decade, biologic agents, in particular infliximab and adalimum-ab, have deeply changed the therapeutic armamentarium of inflammatory bowel disease (IBD). However, these drugs have a number of contraindications and side-effects that physicians should know so to avoid and eventually manage them. Another important issue is the early introduction of immunomodulators and biologics in the therapeutic algorithm of IBD, the so called "top-down" approach compared to the traditional "step-up" approach. In this review, the indications to the use of anti-TNF-alpha molecules in IBD are briefly reported and the potential benefits and disadvantages of a more aggressive approach are discussed.
Papa
A
A
Department of Internal Medicine, Gastroenterology Unit, Catholic University of the Sacred Heart, Rome, Italy. apapa@rm.unicatt.it
Mocci
G
G
Scaldaferri
F
F
Bonizzi
M
M
Felice
C
C
Andrisani
G
G
Gasbarrini
A
A
D000068879:Adalimumab; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D000075202:Contraindications; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab