Efficacy of anti-TNF-alpha monoclonal antibodies in inflammatory bowel disease treatment

Abstract

Efficacy of anti-TNF-alpha monoclonal antibodies in inflammatory bowel disease treatment Amélie Deleporte,1 Stéphanie Viennot,2 Benoît Dupont,2 Cyrielle Gilletta,2 Manon Allaire,2 Frédérique Prévost,1 Jean-Marie Reimund2,3 1Department of Internal Medicine, Digestive Medical Oncology, Institut Jules Bordet, Brussels, Belgium; 2CHU de Caen, Service d'Hépato-Gastro-Entérologie et Nutrition, Pôle Cancérologie et Médecine d'Organes, Caen, France; 3Université de Caen Basse-Normandie, UFR de Médecine, Laboratoire Microenvironnement Cellulaire et Pathologies, Caen, France Abstract: Pathogenesis of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), continues to drive basic research to better decrypt their causal factor(s). Several key mediators involved in IBD pathogenesis have been identified and are considered as potential therapeutic targets. The best example of translational research (from bench to bedside) success is the demonstration that tumor necrosis factor (TNF)-alpha plays a critical role in IBD pathophysiology and that several monoclonal antibodies directed against TNF-alpha are effective tools in IBD treatment. Numerous high quality clinical trials have proven that monoclonal anti-TNF-alpha antibodies (infliximab, adalimumab, and certolizumab pegol) are of great therapeutic value in luminal and/or fistulizing CD or UC, both as induction and as maintenance treatment (health authority approval is dependent on the country and on the antibody being used). Therefore, it is not excessive to state that they have become the mainstay in IBD therapy in 2013. Nevertheless, some important questions related to their use (in particular their long-term use) should be answered in the coming years. This paper reviews the most important data on efficacy and tolerance, and also aims to highlight several future goals for IBD treatment with anti-TNF-alpha monoclonal antibodies. Keywords: anti-TNF-alpha monoclonal antibodies, inflammatory bowel disease, Crohn's disease, ulcerative colitis, therapeutic efficacy