Biologic Drugs in Crohn';s Disease and Ulcerative Colitis: Safety Profile

Abstract

Ulcerative Colitis (UC) and Crohn's Disease (CD) are chronic, progressive and disabling disorders characterized by a heterogeneous clinical course. Some years ago the main goal of the therapy was to achieve and maintain clinical remission, whereas at present the main goal of therapy is represented by the deep remission, characterized by sustained clinical remission, complete mucosal healing and normalization of serological markers of inflammation. In the last years new therapeutic approaches have been introduced which have led to a reduction in the mortality rate and have modified the natural history of Inflammatory Bowel Diseases (IBD). In addition, several prognostic factors have been identified which have allowed to better stratify the disease and to choose the most appropriate therapy for the single patient. Moreover, early treatment with immunosuppressive drugs and/or biologics has changed, at least in the short term, the course of the disease by reducing hospitalization rate and the need for surgery. Therefore, the development of biologic therapies has represented an important step in the treatment of IBD, since these drugs induce remission and response rates that are not achieved by other therapies. Since their use can result in significant adverse events that increase morbidity, patients must be aware of the risks associated with treatment and must be strictly monitored. Although treatment with biologic drugs is not successful in all patients and many of them lose clinical response, new therapies are currently under evaluation.

Herb-partitioned moxibustion alleviates colon injuries in ulcerative colitis rats

“…Although the development and application of oral medications or biological agents for UC have progressed, the treatment results have differed individually, not to mention that adverse effects have often been reported. Some research has proposed the use of more than two drugs together as a multitarget treatment to boost the efficacy, but more research is needed[ 27 ]. Conventional acupuncture-moxibustion therapy can produce a multisystem, multitarget and multidirectional effect, without causing notable adverse reactions.…”

Probiomimetics—Novel Lactobacillus‐Mimicking Microparticles Show Anti‐Inflammatory and Barrier‐Protecting Effects in Gastrointestinal Models

“…[ 10,11 ] Moreover, these drugs are also known to cause a number of side effects, including hepatic injuries and an increased susceptibility to infections. [ 12–14 ] In the case of celiac disease, the patients are required to maintain a lifelong gluten‐free diet, which is difficult to achieve in the typical “western diet” as gluten is contained in a variety of food products, and even very small amounts can trigger an autoimmune reaction. [ 15 ]…”

Double Drug Delivery Using Capped Mesoporous Silica Microparticles for the Effective Treatment of Inflammatory Bowel Disease

“…As an alternative, in the last decade, biological agents (especially anti-TNF (tumor necrosis factor) therapies) have been introduced to be used in UC/CD patients who failed conventional therapy. 23,24 As an alternative to these therapies, nano-and microparticle as drug carriers for oral administration have been tested in experimental colitis models to increase drug efficacy. [25][26][27] However, among different nano-and microparticles, mesoporous silica particles (MSPs) have still been barely studied as carries for IBD treatment.…”