Old and New Biologics and Small Molecules in Inflammatory Bowel Disease: Anti-Tumor Necrosis Factors

• Published in: The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Vol. 84; no. 2; p. 35
• Main Authors: Kim, Sang Un, Lee, Hyun Seok
• Format: Journal Article
• Language: Korean
• Published: Korea (South) 25.08.2024
• Subjects: Adalimumab - therapeutic use; Antibodies, Monoclonal, Humanized - pharmacology; Antibodies, Monoclonal, Humanized - therapeutic use; Biological Products - pharmacology; Biological Products - therapeutic use; Certolizumab Pegol - therapeutic use; Humans; Inflammatory Bowel Diseases - drug therapy; Inflammatory Bowel Diseases - pathology; Infliximab - therapeutic use; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Tumor Necrosis Factor-alpha - metabolism; Inflammatory bowel disease; Crohn's disease; Tumor necrosis factor-αinhibitor; Ulcerative colitis
• ISSN: 2233-6869
• DOI: 10.4166/kjg.2024.060

Inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, is a chronic condition characterized by relapsing and remitting inflammation of the gastrointestinal tract. The pathogenesis involves a complex interplay of genetic, environmental, and immune factors. Treatment paradigms have evolved significantly over the past few decades, with the introduction of biologics, particularly anti-TNF (tumor necrosis factor) agents, marking a significant advancement. Anti-TNF therapies, including infliximab, adalimumab, golimumab, and certolizumab pegol, have efficacy in inducing and maintaining remission, promoting mucosal healing, and improving the quality of life in moderate to severe IBD patients. The early and appropriate use of these agents can mitigate disease progression and reduce the dependency on corticosteroids, enhancing long-term patient outcomes. Nevertheless, these therapies are expensive and are associated with potential adverse effects, including increased risk of infections and malignancies. This review discusses the mechanisms, clinical efficacy, safety profiles, and therapeutic positioning of anti-TNF agents in IBD management, integrating current Korean treatment guidelines.