Infliximab in inflammatory bowel disease
- PMID:30937157
- PMCID: PMC6435871
- DOI: 10.1177/2040622319838443
Infliximab in inflammatory bowel disease
Abstract
Anti-tumor necrosis factor (TNF) therapy has revolutionized the medical treatment of the inflammatory bowel diseases (IBD), Crohn's disease (CD), and ulcerative colitis. Twenty years ago, infliximab became the first anti-TNF agent approved for IBD. Data from randomized controlled trials, large observational cohort studies, postmarketing registries, and meta-analyses show that infliximab is a very effective treatment for moderate to severe IBD with a good safety profile. Infliximab has been also used to treat pouchitis following an ileal pouch-anal anastomosis (IPAA) after restorative proctocolectomy and to prevent postoperative recurrence following an ileocolonic resection for CD with good results. Nevertheless, up to 30% of patients show no clinical benefit following induction and up to 50% lose response over time. Both these unwanted outcomes can be largely explained by inadequate drug concentrations and frequently by the development of antibodies to infliximab. Loss of response can be managed efficiently and often prevented by applying therapeutic drug monitoring. Recently, the first biosimilars of infliximab have been approved and are utilized in clinical practice with comparable efficacy and safety with the originator. This review will mainly focus on the efficacy of infliximab in IBD.
Keywords: Crohn’s disease; anti-TNF therapy; biosimilar; therapeutic drug monitoring; ulcerative colitis.
Conflict of interest statement
Conflict of interest statement: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: A.S.C. has served on advisory boards for Abbvie, Janssen Takeda, Pfizer, Arena, Samsung, Grifols, and Bacainn and has received research support from Miraca. The remaining authors declare no conflict of interest.
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