Insights in immunomodulatory therapies for ulcerative colitis and Crohn's disease

Immunomodulators are a class of drugs that attenuate the underlying inflammatory processes of Crohn's disease (CD) and ulcerative colitis (UC), the two major inflammatory bowel diseases (IBD). These agents play a prominent role in the management of refractory and steroid-dependent IBD. The immu...

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Bibliographic Details
Published in:Current gastroenterology reports 2006-12, Vol.8 (6), p.499-505
Main Authors: Nguyen, Geoffrey C, Harris, Mary L, Dassopoulos, Themistocles
Format: Article
Language:English
Subjects:
Colitis, Ulcerative - drug therapy
Colitis, Ulcerative - immunology
Crohn Disease - drug therapy
Crohn Disease - immunology
Humans
Immunosuppressive Agents - therapeutic use
Treatment Outcome
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Summary:Immunomodulators are a class of drugs that attenuate the underlying inflammatory processes of Crohn's disease (CD) and ulcerative colitis (UC), the two major inflammatory bowel diseases (IBD). These agents play a prominent role in the management of refractory and steroid-dependent IBD. The immunomodulatory drugs in the IBD arsenal include azathioprine, 6-mercaptopurine, methotrexate, cyclosporine, and tacrolimus. Azathioprine and 6-mercaptopurine are considered first-line immunosuppressants due to their proven efficacy in both CD and UC and their safety profile, whereas cyclosporine occupies a niche as a surgery-sparing agent in the acute management of severe, steroid-refractory UC. Immunomodulators also appear to have a role as adjunctive therapy when used with infliximab or other biologic agents to reduce immunogenicity. Although data have been limited to observational studies, azathioprine and 6-mercaptopurine may be used during pregnancy.
ISSN:1522-8037
1534-312X
DOI:10.1007/s11894-006-0040-6