[Pharmacology of biologic medications].
Two major types of inflammatory bowel diseases (IBD) are Crohn's disease (CD) and ulcerative colitis (UC). Insights into their pathophysiology and inflammatory cascade have lead to the discovery of medications that can have a selective effect on a particular molecule or signal pathway and correct an imbalance in pro- and anti-inflammatory mediators. The first to be developed were the TNF-alpha antagonists, soluble receptors like etanercept and monoclonal antibodies. Infliximab has been approved worldwide for treatment of moderate to severe and active fistulizing forms of Crohn's disease, as well as for severe forms of ulcerative colitis in adults who do not react to full and adequate corticosteroid and/or immunosuppressive therapy, i.e. for patients who have problems with or medical contraindications to such therapy and for treatments of severe forms of active disease in children. Adalimumab can be applied in cases when antibodies develop as a reaction to infliximab, leading to reduced drug efficacy and allergic reactions. According to the available data from preclinical tests and earlier phases of clinical tests, potential candidates for new biological medications in treating IBDs are another TNF-alpha antagonist (certolizumab), inhibitors of Th1 polarisation (fontolizumab, ustekinumab) and selective adhesion-molecule inhibitors (natalizumab).
Zavod za gastroenterologiju i hepatologiju, Klinika za unutarnje bolesti Medicinskogfakulteta Sveucilista u Zagrebu, Klinicka bolnica Sveti Duh, Zagreb. marinko.marusic1@zg.t-com.hr
Marinko
M
Marusić
Zavod za gastroenterologiju i hepatologiju, Klinika za unutarnje bolesti Medicinskog fakulteta Sveucilista Josip Juraj Strossmayer, Klinicki bolnicki centar Osijek, Osijek, Hrvatska.
Silvio
S
Mihaljević
D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D000911:Antibodies, Monoclonal / Q000494:pharmacology; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology; D001688:Biological Products / Q000494:pharmacology*; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab; D000069442:Natalizumab; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000494:pharmacology; D000069549:Ustekinumab
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D007166:Immunosuppressive Agents; D000069442:Natalizumab; D014409:Tumor Necrosis Factor-alpha; C505731:fontolizumab; D000069285:Infliximab; D000069549:Ustekinumab; D000068879:Adalimumab