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Positioning biologic therapy for Crohn’s disease and ulcerative colitis

Current Gastroenterology Reports volume 9, pages 521–527 (2007)Cite this article

Abstract

Over the past decade, the introduction of biologic agents such as tumor necrosis factor-α and α4 integrin leukocyte adhesion molecule inhibitors has provided new and effective treatment options for patients with inflammatory bowel disease (IBD). Recent debates have centered on where biologics should be positioned within the current treatment strategy so as to maximize efficacy while balancing risk. This review highlights the current position biologics hold relative to conventional therapies within the current “step-up” treatment strategy. It also critically appraises emerging data, testing the hypothesis that positioning biologics early in the IBD treatment algorithm (“top-down” strategy) results in superior outcomes compared with the current step-up strategy, in which biologics are used only in patients failing conventional therapies or who are steroid dependent.

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Authors and Affiliations

  1. Center for Crohn’s and Colitis, University of California, San Francisco, 2330 Pest Street Suite 610, San Francisco, California, 94115, USA

    Fernando S. Velayos

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  1. Fernando S. Velayos
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  2. William J. Sandborn
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Correspondence to Fernando S. Velayos.

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Velayos, F.S., Sandborn, W.J. Positioning biologic therapy for Crohn’s disease and ulcerative colitis. Curr Gastroenterol Rep 9, 521–527 (2007). https://doi.org/10.1007/s11894-007-0069-1

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  • DOI: https://doi.org/10.1007/s11894-007-0069-1

Keywords

  • Ulcerative Colitis
  • Adalimumab
  • Budesonide
  • Natalizumab
  • Mucosal Healing