Use of Anti-Tumor Necrosis Factors and Anti-Integrins in the Treatment of Crohn's Disease

Gastroenterol Clin North Am. 2017 Sep;46(3):589-601. doi: 10.1016/j.gtc.2017.05.012.

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.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adalimumab / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Certolizumab Pegol / therapeutic use
  • Crohn Disease / complications
  • Crohn Disease / drug therapy*
  • Gastrointestinal Agents / therapeutic use*
  • Health Status
  • Humans
  • Immunologic Factors / therapeutic use*
  • Infliximab / therapeutic use
  • Integrin alpha4 / antagonists & inhibitors
  • Integrin beta Chains
  • Integrins / antagonists & inhibitors*
  • Intestinal Fistula / drug therapy
  • Intestinal Fistula / etiology
  • Maintenance Chemotherapy
  • Natalizumab / therapeutic use
  • Quality of Life
  • Remission Induction
  • Severity of Illness Index
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Gastrointestinal Agents
  • Immunologic Factors
  • Integrin beta Chains
  • Integrins
  • Natalizumab
  • Tumor Necrosis Factor-alpha
  • integrin beta7
  • Integrin alpha4
  • vedolizumab
  • Infliximab
  • Adalimumab
  • Certolizumab Pegol