Book Review

Abstract

This third volume in the Inflammatory Bowel Disease Yearbook series, the first since 2004, is written by an expert panel of physicians with extensive knowledge and experience in inflammatory bowel disease (IBD). Covering six key clinical areas, this book is not meant to be an all-inclusive IBD textbook, but rather a selective update on topics relevant to the practicing gastroenterologist. This book is divided into six chapters, each reviewing an individual topic. The first chapter reviews blood tests in IBD, including their role in IBD diagnosis as well as monitoring disease activity and response to therapy. Chapter 2 outlines the epidemiology of pediatric IBD and a diagnostic approach to these patients. The third chapter provides an update on the genetics of IBD, starting with the importance of the NOD2 gene mutations and the IBD5 haplotype, and then describing other IBD candidate genes. Chapter 4 reviews the evidence for the effectiveness of the purine analogues and methotrexate in IBD therapy, and discusses the current place for these medications in the treatment algorithm. Chapter 5 summarizes the recent evidence for biological therapies in IBD. The final chapter provides an overview of perianal fistulas in Crohn’s disease, focusing on the roles of medical and surgical therapy to provide a practical approach to this difficult clinical problem. Within each chapter, the book is well organized. Titles and subtitles divide the text into concise sections. A number of easily readable figures and tables illustrate key points and summarize important data. References are quoted in the text and are provided at the end of each chapter. The book is relatively small and lightweight, making it easy to pick up and quickly find the desired information. Although a number of topics are covered in this book, practicing clinicians might find the fifth chapter, ‘Biological Therapies’, to be the most informative. Written by Jurgen Scholmerich, this chapter provides a detailed update of biological treatments for IBD. Gut immunology is briefly reviewed, and different therapies are described based on their mechanisms of action. Infliximab receives the most attention, with an update on the role of concomitant immunosuppression to prevent antibodies to infliximab, the use of infliximab in pregnancy and the long-term safety of infliximab. Other agents of interest, such as adalimumab, natalizumab and GM-CSF, among many others, are described; recent clinical trial data for each are summarized. The chapter ends with a look toward the future of biological therapies, alluding to novel mechanisms of action that may provide more targeted treatments for IBD. Although only a select number of subjects are covered in this book, those chosen are ‘hot topics’ in IBD. Recent papers are referenced, and approaches to important clinical problems are given. This third volume in the IBD Yearbook series is a valuable tool for physicians caring for IBD patients, and should be considered as an important addition to the gastroenterology medical library.