Biologics, Small Molecules and More in Inflammatory Bowel Disease: The Present and the Future

M. Manrai, A. Jha, S. Dawra, Aditya Vikram Pachisia
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Abstract

Inflammatory bowel disease (IBD) is a group of heterogeneous chronic inflammatory diseases of the gut presenting with intestinal and extraintestinal manifestations. Most cases fit in predominantly two types, namely, ulcerative colitis and Crohn’s disease. The incidence of IBD has been increasing steadily in the past three decades. Focused research has resulted in many therapeutic options. Biologics (derived from humans or animals) and small molecules have emerged as the cornerstone in the management of IBD and have become widely available. Currently, monoclonal antibodies against tumor necrosis factor-alpha (infliximab, adalimumab, certolizumab, and golimumab), integrins (vedolizumab and natalizumab), and interleukin (IL)-12 and IL-23 antagonists (ustekinumab), along with small molecules (tofacitinib), are approved for use. This article summarizes various aspects of these drugs, like clinical pharmacology, indications for use in IBD, safety in pregnancy and lactation, and the adverse effects profile based on the studies leading to their approval. This review also focuses on the recent advances and future perspectives specific to biologics in IBD.
炎症性肠病中的生物制剂、小分子药物及其他药物:现状与未来
炎症性肠病(IBD)是一组表现为肠道内和肠道外症状的异质性慢性肠道炎症性疾病。大多数病例主要分为两种类型,即溃疡性结肠炎和克罗恩病。在过去的三十年里,IBD 的发病率一直在稳步上升。经过集中研究,产生了许多治疗方案。生物制剂(源自人类或动物)和小分子药物已成为治疗 IBD 的基石,并已广泛应用。目前,针对肿瘤坏死因子-α(英夫利昔单抗、阿达木单抗、certolizumab 和 golimumab)、整合素(vedolizumab 和 natalizumab)、白细胞介素(IL)-12 和 IL-23 拮抗剂(ustekinumab)的单克隆抗体以及小分子药物(托法替尼)已被批准使用。本文概述了这些药物的各个方面,如临床药理学、IBD 适应症、妊娠和哺乳期安全性以及基于研究的不良反应概况,这些研究促成了这些药物的批准。本综述还重点介绍了生物制剂在 IBD 中的最新进展和未来展望。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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