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Approach to Optimize Anti-TNF-α Therapy in Patients With IBD

  • Inflammatory Bowel Disease (G Lichtenstein, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion statement

Tumor necrosis factor-α (TNF-α) is an inflammatory cytokine that plays a major role during the initiation and perpetuation of inflammatory bowel disease (IBD). Anti-TNF-α agents are the most widely used biologics that specifically target either or both circulating and membrane-bound TNF-α, thus preventing its pro-inflammatory activity. Despite their efficacy, one third of the patients receiving anti-TNF-α agents are primary non-responders and nearly half of the patients that initially respond may subsequently lose response (secondary loss of response). Many of these cases can be explained by immunogenicity, which can lead to lower drug levels associated with reduced response and serious adverse effects that cause patients to withdraw from treatment. New treatment algorithms instruct practitioners to check drug and antibody levels when there is loss of response, and then provide guidance towards either dose optimization and/or change in the biologic agent or class to help regain efficacy.

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Authors and Affiliations

  1. Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, The University of Chicago, 5841 S. Maryland Ave. MC 4076, Chicago, Il, 60637, USA

    Yuga Komaki MD, Fukiko Komaki MD, Atsushi Sakuraba MD, PhD & Russell Cohen MD

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  1. Yuga Komaki MD
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  2. Fukiko Komaki MD
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  3. Atsushi Sakuraba MD, PhD
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  4. Russell Cohen MD
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Correspondence to Russell Cohen MD.

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Conflict of Interest

Yuga Komaki and Fukiko Komaki declare that they have no conflict of interest.

Atsushi Sakuraba has received lecture fees from Abbvie, Tanabe-Mitsubishi, and JIMRO.

Russell Cohen has received consultancy fees from Abbvie, UCB Pharma, Johnson & Johnson, and Takeda.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Inflammatory Bowel Disease

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Komaki, Y., Komaki, F., Sakuraba, A. et al. Approach to Optimize Anti-TNF-α Therapy in Patients With IBD. Curr Treat Options Gastro 14, 83–90 (2016). https://doi.org/10.1007/s11938-016-0079-x

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