Emerging Drugs in the Treatment of Inflammatory Bowel Disease: Beyond Anti-TNF-alpha.
10.4166/kjg.2011.58.5.235
- Author:
Kyeong Ok KIM
1
;
Byung Ik JANG
Author Information
1. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. jbi@med.yu.ac.kr
- Publication Type:Review ; English Abstract ; Research Support, Non-U.S. Gov't
- Keywords:
Inflammatory bowel disease;
Therapeutics;
Infliximab;
Biological products
- MeSH:
Antibodies, Monoclonal/therapeutic use;
Cell Migration Inhibition;
Colony-Stimulating Factors/therapeutic use;
Cytokines/antagonists & inhibitors;
Gene Therapy;
Humans;
Immunosuppressive Agents/therapeutic use;
Inflammatory Bowel Diseases/drug therapy/*therapy;
Intercellular Signaling Peptides and Proteins/therapeutic use;
Mitogen-Activated Protein Kinases/antagonists & inhibitors;
Stem Cell Transplantation;
Tumor Necrosis Factor-alpha/*antagonists & inhibitors/immunology
- From:The Korean Journal of Gastroenterology
2011;58(5):235-244
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Understanding of the pathophysiology of inflammatory bowel disease (IBD) is constantly evolving and, recently, a number of biologic agents have been developed. They selectively target specific molecule or pathways and correct the imbalance of the gut immune system. Among them, antibody to tumor necrosis factor (anti-TNF-alpha) is the first developed drugs, and it dramatically improved the IBD management. However, more than one-third of the patients do not respond to the drugs due to antibody formation. To increase treatment efficacy, enormous effort to develop novel anti-cytokines which can be an alternative to anti-TNF-alpha has been made. They are anti CD4+ T cell cytokine including interleukin (IL)-12/23 and IL-17 blockers, selective anti-adhesion molecule known as natalizumab, vedolizumab and alicaforsen, T-cell proliferation inhibitor, anti-inflammatory cytokine, immune stimulator, growth factor, and mitogen-activated protein kinase inhibitor. The efficacy and safety of each drugs are under investigation. Some drugs reported very promising data, however, others showed disappointing and different results. In addition, most of the trials were done in a very small number of patients, and there is no trial comparing to anti-TNF-alpha. The present paper reviews the action mechanism, short or long term efficacy and safety of variable drugs other than anti-TNF-alpha in IBD.
