1,721,304 research outputs found
The role of healthcare providers in accompanying biosimilars in inflammatory bowel diseases
No full textNon-biological therapy in inflammatory bowel disease-old and new evidence
No full textThe medical therapy for inflammatory bowel disease has changed during recent years because of new molecular pathogenetic findings and the consequent development of more specific agents, such as biologicals. The principal goal of treatment aims to modify the natural course of these chronic progressive diseases in high-risk patients. However, 'non-biological' therapies still maintain a fundamental role because of their validated efficacy in several clinical settings. In a comprehensive review, the most important concept remains that therapy should be personalised for each patient, evaluating the risks and benefits of all therapeutic approaches in the specific clinical context. In this review, the effectiveness of steroids, mesalazine, antibiotics and immunosuppressive agents is evaluated on the basis of old and new evidence, along with a summary of the recommendations of the corresponding international guidelines. © Touch Briefings 2012
Inducing remission of ulcerative colitis: are clinicians better equipped than ever?
No full textno abstract availabl
Biological therapies for inflammatory bowel disease: Research drives clinics
No full textThe better understanding of the mechanisms of inflammatory bowel disease has driven our progress into the development of new biological therapies targeting specific molecules. Anti-TINIF-alpha biologic compounds have shown great efficacy particularly in Crohn's disease. Infliximab (an IgG1 mouse/human chimeric monoclonal anti-TNF-alpha(x antibody fragment) is the most efficacious compound in induction and maintenance therapy of active and fistulizing Crohn's disease. being at present the only biological Compound approved for therapy, but with the limit of the immunogenicity; CDP-571 (a humanized anti-TNF-alpha antibody) and CDP-870 (a PFGylated anti-TNF-alpha antibody) are less immunogenic, showed some efficacy in induction therapy in Crohn's disease but a rapid loss of response in maintenance therapy. Etanercept and onercept (soluble human recombinant TNF-alpha receptors fusion proteins) seem not to be efficacious in Crohn's disease demonstrating no class-effect for anti-TNF-alpha compounds. In preliminary study, adalimumab (an IgG1 humanized monoclonal anti-i-TNF-alpha antibody) offers good perspective of efficacy and safety also in inflixmab-resistant or allergic patients. Inhibition of lymphocyte trafficking to the gut, through anti-adhesion molecules specific therapies (natalizumab. MLN-02, alicaforsen), has shown promising results: unfortunately, natalizumab, the most effective drug of this class, has recently been suspected to favour serious neurological complications. Other biologic therapies are under evaluation but at present seem to be less promising than infliximab; they consist of antiinflammatory cytokines, inhibitors of proinflammatory cytokines, hormones and growth factors: anti-IL-2-antibody, interferon-alpha, interferon-beta, G-CSF, GM-CSF, EGF, growth hormone, anti-interferon-gamma, anti-IL-18, anti-IL-2-receptor and anti-CD3 antibodies. The evaluation of other biological drugs has been Suspended for severe side effects as happened for anti-CD40L antibody causing thromboembolism and anti-CD4 antibody causing lymphopenia. Other compounds as IL-10 and IL-11 have been proven to be ineffective even if an oral formulation of IL-11 is under evaluation. Among the MAP kinases inhibitors BIRB-796 and RDP58 showed to be ineffective while CNI-1493 is under evaluation. The effort in identifying specific patients features predicting therapy response and the possible combination of different biolopical therapies represent undoubtedly a very promising perspective. Aim of this article is to review the biological Compounds and their efficacy in IBD
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