Infliximab in inflammatory bowel disease

Abstract

Anti-tumor necrosis factor (TNF) therapy has revolutionized the medical treatment of the inflammatory bowel diseases (IBD), Crohn’s disease (CD), and ulcerative colitis. Twenty years ago, infliximab became the first anti-TNF agent approved for IBD. Data from randomized controlled trials, large observational cohort studies, postmarketing registries, and meta-analyses show that infliximab is a very effective treatment for moderate to severe IBD with a good safety profile. Infliximab has been also used to treat pouchitis following an ileal pouch–anal anastomosis (IPAA) after restorative proctocolectomy and to prevent postoperative recurrence following an ileocolonic resection for CD with good results. Nevertheless, up to 30% of patients show no clinical benefit following induction and up to 50% lose response over time. Both these unwanted outcomes can be largely explained by inadequate drug concentrations and frequently by the development of antibodies to infliximab. Loss of response can be managed efficiently and often prevented by applying therapeutic drug monitoring. Recently, the first biosimilars of infliximab have been approved and are utilized in clinical practice with comparable efficacy and safety with the originator. This review will mainly focus on the efficacy of infliximab in IBD.

Diagnostic and Management Approach to Pouchitis in Inflammatory Bowel Disease

“…Biological therapy has been used as a rescue treatment in those patients who have not responded to antibiotic therapy (74) . In a retrospective Belgian study that included 28 patients with refractory pouchitis treated with Infliximab 5 mg/kg every eight weeks, showed that 88% presented a clinical response at 10 weeks, which was maintained in 56% of patients at 20 weeks (75) .…”

Effects of kampo medicine keishikashakuyakuto on large intestine disease in mice

“…97) exceeded 160 000 in 2013, and the number of IBD patients is increasing . Corticosteroids, 5‐aminosalicylic acid, immune modulators, such as thiopurine and methotrexate , biological drugs, and anti‐tumor necrosis factor (TNF) antibody are used for the treatment of IBD in both CD and UC patients. We previously reported that Swertia japonica extract and its main compound swertiamarine, and Atractylodes lancea rhizome extract and a volatile component β‐eudesmol stimulated gastric emptying and/or small intestine motility by inhibiting the dopamine D 2 and/or 5‐HT receptor .…”

Efficient treatment of a preclinical inflammatory bowel disease model with engineered bacteria

“…This treatment option has several drawbacks that warrant the development of alternative treatments, such as high cost, severe potentially lethal side effects and the fact that up to 50% of patients do not respond or lose sensitivity to this treatment over time 1 .…”