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Pal Miheller, Agnes Anna Csontos, Zsuzsanna Vegh1, András Gelley, Peter L. Lakatos
Introduction: There was a recent revolution in the medical therapy of inflammatory bowel disease with the advent of anti-TNF inhibitors. Treatment paradigms have evolved from a slow step-up approach to accelerated care with early introduction of immunosuppression and biologicals.
Areas covered: The authors review clinical efficacy and safety of new anti-TNFs and new action biologicals including anti-cytokine therapies and cell adhesion inhibitors in both Crohn’s disease. Some of the agents were already approved by both FDA and EMA.
Expert opinion: Anti-TNF agents will remain the mainstay of biological therapy in in Crohn’s disease in the near future. However; the proportion of anti-TNF refractory patient population is growing. In addition; there is a change in the cost structure of inflammatory dowel disease and anti-TNFs became responsible for a great proportion of the direct costs; therefore new biolologicals including biosimilar anti-TNFS are urgently awaited. The addition of these drugy into the armamentarium will provide additional treatment option for both bionaive and refractory patients and hopefully it will lead to improved outcomes and on the long run to a lesser economic burden of the disease.