title: Optimizing biological therapy in Crohn's disease.
abstract: Anti-TNF therapy has revolutionized the treatment of inflammatory bowel diseases, including both Crohn's disease and ulcerative colitis. However, a significant proportion of patients does not respond to anti-TNF agents or lose response over time. Recently, therapeutic drug monitoring has gained a major role in identifying the mechanism and management of loss of response. The aim of this review article is to summarize the predictors of efficacy and outcomes, the different mechanisms of anti-TNF/biological failure in Crohn's disease and identify strategies to optimize biological treatment.
authors.affiliation: a First Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Krisztina Barbara
authors.initials: KB
authors.lastname: Gecse
authors.affiliation: a First Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Végh
authors.forename: Péter László
authors.initials: PL
authors.lastname: Lakatos
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001691:Biological Therapy; D000068582:Certolizumab Pegol / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy*; D016903:Drug Monitoring; D004361:Drug Tolerance; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D012307:Risk Factors; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; C543529:vedolizumab; D000069285:Infliximab; D000068879:Adalimumab; D000068582:Certolizumab Pegol
keywords: Crohn’s disease; adalimumab; infliximab; therapeutic drug level monitoring; ulcerative colitis