title: Therapy of inflammatory bowel disease: what to expect in the next decade.
abstract: OBJECTIVE
  The increased understanding of the molecular mechanisms that are responsible for inflammatory bowel disease (IBD) has led to a wide range of potential therapeutic targets for this condition. Physicians treating individuals with Crohn's disease and ulcerative colitis have a growing armamentarium of options to choose from in managing these patients. This article aims to summarize the relevant literature in the area of emerging therapy in IBD.
  
  
  RESULTS
  The widespread use of antitumor necrosis factor medications brought a landmark change in the treatment of IBD. More recently, several drugs have been shown to provide benefit in IBD in phase III studies by blocking other antiinflammatory pathways. The most likely new medications that will be available include vedolizumab for ulcerative colitis and ustekinumab for Crohn's disease, which target cellular adhesion and inflammatory cell signaling, respectively. Other promising drugs focus on blockade of Janus kinase, inhibition of various chemokines, and biologic therapy such as hematopoietic stem cell transplants and mesenchymal cell infusions.
  
  
  CONCLUSIONS
  The growing understanding of the pathogenesis of IBD has led to new molecular targets for therapy. Over the next decade, the number of treatments available will grow, targeting cellular adhesion, protein regulation, inflammatory signal pathways, and immune tolerance.
authors.affiliation: Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Leiman
authors.forename: Gary R
authors.initials: GR
authors.lastname: Lichtenstein
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000639:trends*; D006801:Humans; D058990:Molecular Targeted Therapy / Q000639:trends*; D000069442:Natalizumab; D015398:Signal Transduction / Q000187:drug effects; D013449:Sulfonamides / Q000627:therapeutic use; D016896:Treatment Outcome; D000069549:Ustekinumab
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; C583420:CCX282-B; D000069442:Natalizumab; D013449:Sulfonamides; C543529:vedolizumab; D000069549:Ustekinumab