医学
英夫利昔单抗
炎症性肠病
加药
维多利祖马布
妥珠单抗
溃疡性结肠炎
免疫抑制
重症监护医学
克罗恩病
免疫学
疾病
肿瘤坏死因子α
相伴的
阿达木单抗
内科学
作者
Suzanne I. Anjie,Melanie S. Hulshoff,Geert D’Haens
标识
DOI:10.1080/14712598.2023.2198086
摘要
Introduction During the last decades, biologics have revolutionized the treatment of Crohn’s disease and ulcerative colitis. Even though the inflammatory bowel disease (IBD) armamentarium is rapidly expanding with novel biologics, anti-tumor necrosis factor (TNF) antibodies remain the first-line biologic therapy in most areas of the world. However, anti-TNF therapy is not effective in all patients (primary non-response) and patients can lose effect over time (secondary loss of response).Areas covered This review provides an overview of the current induction and maintenance dosing regimens of the available anti-TNF antibodies and associated challenges in adult patients with IBD. We outline different strategies to overcome these difficulties, including combination therapy, therapeutic drug monitoring (TDM), and dose escalation. Finally, we discuss expected future progress in anti-TNF management.Expert opinion Anti-TNF agents will remain a cornerstone of IBD treatment in the coming decade. Progress will be made in biomarkers for the prediction of response and individualized dosing regimens. The advent of subcutaneous infliximab challenges the need for concomitant immunosuppression.
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