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Current Status of Medical Therapy for Inflammatory Bowel Disease: The Wealth of Medications

Previously, the natural history of Crohn’s disease and ulcerative colitis included significant morbidity due to limited treatment options that were not without serious side effects. Early treatment options included corticosteroids as well as mesalamine, thiopurines, and methotrexate. In 1998, monocl...

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Published in:Digestive diseases and sciences 2020-10, Vol.65 (10), p.2769-2779
Main Authors: Nadpara, Neil, Reichenbach, Zachary Wilmer, Ehrlich, Adam C., Friedenberg, Frank
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creator Nadpara, Neil
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Ehrlich, Adam C.
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description Previously, the natural history of Crohn’s disease and ulcerative colitis included significant morbidity due to limited treatment options that were not without serious side effects. Early treatment options included corticosteroids as well as mesalamine, thiopurines, and methotrexate. In 1998, monoclonal antibodies to a key inflammatory cytokine, TNFα, became available. Over the next 22 years, the field of gastroenterology has seen multiple new treatments emerging for inflammatory bowel disease (IBD) that target different aspects of the inflammatory cascade, significantly changing the therapeutic landscape. Additional monoclonal antibodies are available that target the integrins, which are adhesion proteins that traffic inflammatory leukocytes. Small molecule inhibitors block the inflammatory signals of several cytokines. New therapies that modulate lymphocyte escape from lymphoid tissue are promising. Lastly, stem cell technology has emerged as a platform to successfully treat perianal fistulizing disease. Our aim is to summarize the currently available therapies for IBD beyond steroids, mesalamine, and immune modulators. We highlight the most important clinical trials that have brought these treatments to clinical practice, and we discuss the ongoing clinical trials of novel therapies that have a high probability of eventual regulatory approval.
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subjects Adalimumab
Animals
Anti-Inflammatory Agents - adverse effects
Anti-Inflammatory Agents - therapeutic use
B cells
Biochemistry
Care and treatment
Clinical trials
Colitis, Ulcerative - drug therapy
Colitis, Ulcerative - immunology
Colitis, Ulcerative - pathology
Crohn Disease - drug therapy
Crohn Disease - immunology
Crohn Disease - pathology
Crohn's disease
Cytokines
Drug therapy
Gastroenterology
Gastrointestinal Agents - adverse effects
Gastrointestinal Agents - therapeutic use
Health aspects
Hepatology
Humans
Inflammatory bowel disease
Intestines - drug effects
Intestines - immunology
Intestines - pathology
Medical colleges
Medicine
Medicine & Public Health
Mentored Review
Molecular Targeted Therapy
Monoclonal antibodies
Oncology
Stem cells
Tofacitinib
Transplant Surgery
Transplantation
Tumor necrosis factor
Ulcerative colitis
title Current Status of Medical Therapy for Inflammatory Bowel Disease: The Wealth of Medications
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