Clinical Review State of the Art Review

Update on anti-tumor necrosis factor agents and other new drugs for inflammatory bowel disease

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2505 (Published 19 June 2017) Cite this as: BMJ 2017;357:j2505
  1. Benjamin L Cohen, assistant professor of medicine1,
  2. David B Sachar, clinical professor of medicine1
  1. 1Susan and Leonard Feinstein Inflammatory Bowel Disease Center, Dr Henry D Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
  1. Correspondence to: B L Cohen benjamin.cohen{at}mssm.edu

Abstract

The treatment of inflammatory bowel disease (IBD)—ulcerative colitis (UC) and Crohn’s disease (CD)—has evolved beyond surgery with the introduction of biologic agents, primarily antibodies against mediators of inflammation and cell attraction. Anti-tumor necrosis factor (TNF) agents have been the first line treatment for moderate to severe ulcerative colitis and Crohn’s disease for more than 15 years. During that time much has been learnt about how best to use these agents. This review will assess the evidence on how to optimize the use of anti-TNF agents; when and how to start treatment; how to monitor treatment and when to de-escalate it; and the potential adverse effects of these drugs. New and emerging treatments such as anti-attractants, anti-interleukins, and Janus kinase (JAK) inhibitors will also be discussed.

Footnotes

  • Series explanation: State of the Art Reviews are commissioned on the basis of their relevance to academics and specialists in the US and internationally. For this reason they are written predominantly by US authors

  • Contributors: BLC and DBS contributed equally to the literature review, writing, and reviewing of the manuscript.

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work. BLC has done consultancy work for Celltrion; he has served on advisory boards for Abbvie and Janssen; and he has performed expert witness work for Allergan. The authors have no other relationships or activities that could appear to have influenced the submitted work.

  • Provenance and peer review: Commissioned; externally peer reviewed.

View Full Text

Sign in

Log in through your institution

Free trial

Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
Sign up for a free trial

Subscribe