Inhibitors of Tumoral Necrosis Factor Alpha in Inflammatory Bowel Disease

Abstract

The treatment of inflammatory bowel disease (IBD) has undergone a major paradigm shift in the last two decades with the introduction of biological drugs. Tumoral necrosis factor (TNF) antagonists were the first monoclonal antibodies available for treatment of IBD. New emerging concepts as early initiation of treatment during the “ opportunity window, ” and “ treat to target ” with a tight control strategy have contributed to optimum utilization of these drugs allowing better long-term outcomes for treated patients. This chapter aims to review all current pivotal data regarding efficacy and safety of infliximab, adalimumab, certolizumab pegol, and golimumab, as long as real life experience with these agents. Comparative efficacy among anti-TNF agents and the role of therapeutic drug monitoring in the management of IBD will also be discussed. Last, the authors present future perspectives with the drugs and position anti-TNF agents as viable therapeutic options in the current IBD therapeutic armamentarium.