Abstract
In patients with Crohn's disease (CD), anti-tumor necrosis factor (TNF) therapy is efficacious for the induction and maintenance of clinical remission, mucosal healing, reducing rates of surgery and hospitalizations, and improving health-related quality of life. The decision between anti-TNFs and anti-integrins as first-line treatment in CD depends on disease severity, safety concerns, and prescription coverage. Given the existing data on long-term outcomes and safety, anti-TNFs are often preferred to anti-integrins. Additional clinical experience and preferably prospective, head-to-head studies will be important to determine whether vedolizumab should be considered more often for first-line therapy in CD.
Keywords:
Anti-TNFs; Anti-integrins; Biologics; Crohn's disease; Treatment.
Copyright © 2017 Elsevier Inc. All rights reserved.
Publication types
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Review
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Research Support, Non-U.S. Gov't
MeSH terms
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Adalimumab / therapeutic use
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Antibodies, Monoclonal, Humanized / therapeutic use
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Antirheumatic Agents / therapeutic use*
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Certolizumab Pegol / therapeutic use
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Crohn Disease / complications
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Crohn Disease / drug therapy*
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Gastrointestinal Agents / therapeutic use*
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Health Status
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Humans
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Immunologic Factors / therapeutic use*
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Infliximab / therapeutic use
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Integrin alpha4 / antagonists & inhibitors
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Integrin beta Chains
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Integrins / antagonists & inhibitors*
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Intestinal Fistula / drug therapy
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Intestinal Fistula / etiology
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Maintenance Chemotherapy
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Natalizumab / therapeutic use
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Quality of Life
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Remission Induction
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Severity of Illness Index
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Treatment Outcome
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Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Substances
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Antibodies, Monoclonal, Humanized
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Antirheumatic Agents
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Gastrointestinal Agents
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Immunologic Factors
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Integrin beta Chains
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Integrins
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Natalizumab
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Tumor Necrosis Factor-alpha
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integrin beta7
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Integrin alpha4
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vedolizumab
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Infliximab
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Adalimumab
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Certolizumab Pegol