Biologics for Ulcerative Colitis: Status of the Art and General Considerations

Background: Expanding over Crohn’s disease in the Far East, and easily biased to chronicity, ulcerative colitis (UC) continues to pose a challenge. Traditional remedies have been based on control of inflammation and immune suppression, effected by such classic drugs as mesalamines, corticosteroids,...

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Autor principal:	Giovanni Clemente Actis
Formato:	article
Lenguaje:	EN
Publicado:	Shiraz University of Medical Sciences 2017
Materias:	inflammatory bowel disease biologics immune suppression Medicine R
Acceso en línea:	https://doaj.org/article/a2143df2e2bd49bb8755ba4f01f0045d
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spelling	oai:doaj.org-article:a2143df2e2bd49bb8755ba4f01f0045d2021-11-16T07:43:30ZBiologics for Ulcerative Colitis: Status of the Art and General Considerations2783-2430https://doaj.org/article/a2143df2e2bd49bb8755ba4f01f0045d2017-03-01T00:00:00Zhttps://colorectalresearch.sums.ac.ir/article_47154_6e8ef305fa5b9a31b31a1aeead17ec8b.pdfhttps://doaj.org/toc/2783-2430Background: Expanding over Crohn’s disease in the Far East, and easily biased to chronicity, ulcerative colitis (UC) continues to pose a challenge. Traditional remedies have been based on control of inflammation and immune suppression, effected by such classic drugs as mesalamines, corticosteroids, and thiopurines. However, these molecules have long proven unable to fully controlthe disease or modify disease history, leaving an alternative fully desirable.Objectives: In this study, we aimed at highlighting the indications for biological therapy in UC.Methods: Literature review.Results: Recently, it has been demonstrated that the proinflammatory cytokine tumor necrosis factor (TNF) plays a significant role in UC, opening a way for anti-TNF biologics to join the therapeutic arsenal. These monoclonal antibodies, now available as hybrids or fully human preparations, are able to attain at least 50% response rate of refractory UC. However, primary non-response amountsto 20% - 40%, and loss of response to 40%. Optimization protocols allow for biologic molecule switching (disease symptoms, antibody positive) or replacement with another drug class (symptoms but no antibodies). Infectious/neoplastic /autoimmune toxicities together with high costs continue to be a problem (52%).Conclusions: These results warrant further therapeutic leaps forward: personalized therapy plans based on the patiens’ genetic profile, and pre-emptive measures based on people’s education to modify diet and life habits.Giovanni Clemente ActisShiraz University of Medical Sciencesarticleinflammatory bowel diseasebiologicsimmune suppressionMedicineRENIranian Journal of Colorectal Research, Vol 5, Iss Issues 1-2, Pp 1-5 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	inflammatory bowel disease biologics immune suppression Medicine R
spellingShingle	inflammatory bowel disease biologics immune suppression Medicine R Giovanni Clemente Actis Biologics for Ulcerative Colitis: Status of the Art and General Considerations
description	Background: Expanding over Crohn’s disease in the Far East, and easily biased to chronicity, ulcerative colitis (UC) continues to pose a challenge. Traditional remedies have been based on control of inflammation and immune suppression, effected by such classic drugs as mesalamines, corticosteroids, and thiopurines. However, these molecules have long proven unable to fully controlthe disease or modify disease history, leaving an alternative fully desirable.Objectives: In this study, we aimed at highlighting the indications for biological therapy in UC.Methods: Literature review.Results: Recently, it has been demonstrated that the proinflammatory cytokine tumor necrosis factor (TNF) plays a significant role in UC, opening a way for anti-TNF biologics to join the therapeutic arsenal. These monoclonal antibodies, now available as hybrids or fully human preparations, are able to attain at least 50% response rate of refractory UC. However, primary non-response amountsto 20% - 40%, and loss of response to 40%. Optimization protocols allow for biologic molecule switching (disease symptoms, antibody positive) or replacement with another drug class (symptoms but no antibodies). Infectious/neoplastic /autoimmune toxicities together with high costs continue to be a problem (52%).Conclusions: These results warrant further therapeutic leaps forward: personalized therapy plans based on the patiens’ genetic profile, and pre-emptive measures based on people’s education to modify diet and life habits.
format	article
author	Giovanni Clemente Actis
author_facet	Giovanni Clemente Actis
author_sort	Giovanni Clemente Actis
title	Biologics for Ulcerative Colitis: Status of the Art and General Considerations
title_short	Biologics for Ulcerative Colitis: Status of the Art and General Considerations
title_full	Biologics for Ulcerative Colitis: Status of the Art and General Considerations
title_fullStr	Biologics for Ulcerative Colitis: Status of the Art and General Considerations
title_full_unstemmed	Biologics for Ulcerative Colitis: Status of the Art and General Considerations
title_sort	biologics for ulcerative colitis: status of the art and general considerations
publisher	Shiraz University of Medical Sciences
publishDate	2017
url	https://doaj.org/article/a2143df2e2bd49bb8755ba4f01f0045d
work_keys_str_mv	AT giovanniclementeactis biologicsforulcerativecolitisstatusoftheartandgeneralconsiderations
_version_	1718426622982356992

Biologics for Ulcerative Colitis: Status of the Art and General Considerations

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