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The current state of the art for biological therapies and new small molecules in inflammatory bowel disease

Mucosal Immunology (2018) | Download Citation

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Abstract

The emergence of biologic therapies is arguably the greatest therapeutic advance in the care of inflammatory bowel disease (IBD) to date, allowing directed treatments targeted at highly specific molecules shown to play critical roles in disease pathogenesis, with advantages in potency and selectivity. Furthermore, a large number of new biologic and small-molecule therapies in IBD targeting a variety of pathways are at various stages of development that should soon lead to a dramatic expansion in our therapeutic armamentarium. Additionally, since the initial introduction of biologics, there have been substantial advances in our understanding as to how biologics work, the practical realities of their administration, and how to enhance their efficacy and safety in the clinical setting. In this review, we will summarize the current state of the art for biological therapies in IBD, both in terms of agents available and their optimal use, as well as preview future advances in biologics and highly targeted small molecules in the IBD field.

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Acknowledgements

The authors like to thank Jill Gregory, Associate Director of Instructional Technology at the Icahn School of Medicine at Mount Sinai for creating the figure illustrations. This work was supported by the following grants: Mt Sinai (New York) SUCCESS fund - GCO14-0560 (JFC), Takeda Pharmaceuticals Investigator Initiated Research Grant (JFC), NIH/NIDDK R01 DK112296 (SM), Rainin Foundation Synergy Award (SM). Additionally, A.K.R. was supported by the Digestive Disease Research Foundation (DDRF).

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Affiliations

  1. Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    • Sudarshan Paramsothy
    • , Adam K. Rosenstein
    • , Saurabh Mehandru
    •  & Jean-Frederic Colombel
  2. PrIISM Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    • Adam K. Rosenstein
    •  & Saurabh Mehandru

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Contributions

S.P., S.M., and J.F.C. planned the manuscript. S.P. and A.K.R. drafted the manuscript. S.M. and J.F.C. reviewed the manuscript for its intellectual content.

Competing interests

S.P., A.K.R., and S.M. declare no competing interests. J.F.C. has served as consultant or advisory board member for AbbVie, Amgen, Boehringer-Ingelheim, Arena Pharmaceuticals, Celgene Corporation, Celltrion, Enterome, Eli Lilly, Ferring Pharmaceuticals, Genentech, Janssen and Janssen, Medimmune, Merck & Co., Nextbiotix, Novartis Pharmaceuticals Corporation, Otsuka Pharmaceutical Development & Commercialization, Inc., Pfizer, Protagonist, Second Genome, Gilead, Seres Therapeutics, Shire, Takeda, Theradiag; speaker for AbbVie, Ferring, Takeda, Celgene Corporation. He has stock options with Intestinal Biotech Development and Genefit; he has research grants from AbbVie, Takeda, Janssen and Janssen.

Corresponding author

Correspondence to Jean-Frederic Colombel.

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https://doi.org/10.1038/s41385-018-0050-3