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Insights in immunomodulatory therapies for ulcerative colitis and Crohn’s disease

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Abstract

Immunomodulators are a class of drugs that attenuate the underlying inflammatory processes of Crohn’s disease (CD) and ulcerative colitis (UC), the two major inflammatory bowel diseases (IBD). These agents play a prominent role in the management of refractory and steroid-dependent IBD. The immunomodulatory drugs in the IBD arsenal include azathioprine, 6-mercaptopurine, methotrexate, cyclosporine, and tacrolimus. Azathioprine and 6-mercaptopurine are considered firstline immunosuppressants due to their proven efficacy in both CD and UC and their safety profile, whereas cyclosporine occupies a niche as a surgery-sparing agent in the acute management of severe, steroid-refractory UC. Immunomodulators also appear to have a role as adjunctive therapy when used with infliximab or other biologic agents to reduce immunogenicity. Although data have been limited to observational studies, azathioprine and 6-mercaptopurine may be used during pregnancy.

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Authors and Affiliations

  1. Division of Gastroenterology, The Johns Hopkins Hospital, 600 North Wolfe Street/Blalock 461, 21287, Baltimore, MD, USA

    Themistocles Dassopoulos MD

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  1. Geoffrey C. Nguyen MD
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  2. Mary L. Harris MD
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  3. Themistocles Dassopoulos MD
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Correspondence to Themistocles Dassopoulos MD.

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Nguyen, G.C., Harris, M.L. & Dassopoulos, T. Insights in immunomodulatory therapies for ulcerative colitis and Crohn’s disease. Curr Gastroenterol Rep 8, 499–505 (2006). https://doi.org/10.1007/s11894-006-0040-6

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