Biologic therapies in inflammatory bowel disease.
Inflammatory bowel disease, including its 2 entities ulcerative colitis and Crohn's disease, is a chronic medical condition characterized by the destructive inflammation of the intestinal tract. Biologics represent a class of therapeutics with immune intervention potential. These agents block the proinflammatory cascade that triggers the activation and proliferation of T lymphocytes at the level of the intestine, therefore reestablishing the balance between the pro- and anti-inflammatory messages. All 7 biologics showing clinical benefits in inflammatory bowel disease are monoclonal antibodies. The following systematic review discusses the pharmacokinetics and efficacy of the tumor necrosis factor blockers infliximab, adalimumab, certolizumab pegol, and golimumab. In addition, we describe the α4 integrin inhibitors natalizumab and vedolizumab, which are directed against cell adhesion molecules, as well as the interleukin 12/23 blocker ustekinumab.
Division of Gastroenterology, Sunnybrook Health Science Centre, Toronto, Ontario, Canada; Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada.
Lawrence B
LB
Cohen
Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; In Vitro Drug Safety and Biotechnology, Toronto, Ontario, Canada.
Radu M
RM
Nanau
In Vitro Drug Safety and Biotechnology, Toronto, Ontario, Canada.
Faustine
F
Delzor
Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; In Vitro Drug Safety and Biotechnology, Toronto, Ontario, Canada. Electronic address: manuela.neuman@utoronto.ca.
Manuela G
MG
Neuman
D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000493:pharmacokinetics / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000493:pharmacokinetics; D001688:Biological Products / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000068582:Certolizumab Pegol; D002986:Clinical Trials as Topic; D003093:Colitis, Ulcerative / Q000276:immunology / Q000628:therapy; D003424:Crohn Disease / Q000276:immunology / Q000628:therapy; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments; D015212:Inflammatory Bowel Diseases / Q000276:immunology / Q000628:therapy*; D000069285:Infliximab; D008297:Male; D000069442:Natalizumab; D011092:Polyethylene Glycols / Q000493:pharmacokinetics; D057170:Translational Research, Biomedical; D000069549:Ustekinumab
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D007140:Immunoglobulin Fab Fragments; D000069442:Natalizumab; D011092:Polyethylene Glycols; C529000:golimumab; C543529:vedolizumab; D000069285:Infliximab; D000069549:Ustekinumab; D000068879:Adalimumab; D000068582:Certolizumab Pegol