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Precision medicine in inflammatory bowel disease: Individualizing the use of biologics and small molecule therapies
The advent of biologics and small molecules in inflammatory bowel disease (IBD) has marked a significant turning point in the prognosis of IBD, decreasing the rates of corticosteroid dependence, hospitalizations and improving overall quality of life. The introduction of biosimilars has also increase...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Baishideng Publishing Group Inc
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037250/ https://www.ncbi.nlm.nih.gov/pubmed/36970587 http://dx.doi.org/10.3748/wjg.v29.i10.1539 |
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author | Cheah, Eric Huang, James Guoxian |
author_facet | Cheah, Eric Huang, James Guoxian |
author_sort | Cheah, Eric |
collection | PubMed |
description | The advent of biologics and small molecules in inflammatory bowel disease (IBD) has marked a significant turning point in the prognosis of IBD, decreasing the rates of corticosteroid dependence, hospitalizations and improving overall quality of life. The introduction of biosimilars has also increased affordability and enhanced access to these otherwise costly targeted therapies. Biologics do not yet represent a complete panacea: A subset of patients do not respond to first-line anti-tumor necrosis factor (TNF)-alpha agents or may subsequently demonstrate a secondary loss of response. Patients who fail to respond to anti-TNF agents typically have a poorer response rate to second-line biologics. It is uncertain which patient would benefit from a different sequencing of biologics or even a combination of biologic agents. The introduction of newer classes of biologics and small molecules may provide alternative therapeutic targets for patients with refractory disease. This review examines the therapeutic ceiling in current treatment strategies of IBD and the potential paradigm shifts in the future. |
format | Online Article Text |
id | pubmed-10037250 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-100372502023-03-25 Precision medicine in inflammatory bowel disease: Individualizing the use of biologics and small molecule therapies Cheah, Eric Huang, James Guoxian World J Gastroenterol Review The advent of biologics and small molecules in inflammatory bowel disease (IBD) has marked a significant turning point in the prognosis of IBD, decreasing the rates of corticosteroid dependence, hospitalizations and improving overall quality of life. The introduction of biosimilars has also increased affordability and enhanced access to these otherwise costly targeted therapies. Biologics do not yet represent a complete panacea: A subset of patients do not respond to first-line anti-tumor necrosis factor (TNF)-alpha agents or may subsequently demonstrate a secondary loss of response. Patients who fail to respond to anti-TNF agents typically have a poorer response rate to second-line biologics. It is uncertain which patient would benefit from a different sequencing of biologics or even a combination of biologic agents. The introduction of newer classes of biologics and small molecules may provide alternative therapeutic targets for patients with refractory disease. This review examines the therapeutic ceiling in current treatment strategies of IBD and the potential paradigm shifts in the future. Baishideng Publishing Group Inc 2023-03-14 2023-03-14 /pmc/articles/PMC10037250/ /pubmed/36970587 http://dx.doi.org/10.3748/wjg.v29.i10.1539 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Review Cheah, Eric Huang, James Guoxian Precision medicine in inflammatory bowel disease: Individualizing the use of biologics and small molecule therapies |
title | Precision medicine in inflammatory bowel disease: Individualizing the use of biologics and small molecule therapies |
title_full | Precision medicine in inflammatory bowel disease: Individualizing the use of biologics and small molecule therapies |
title_fullStr | Precision medicine in inflammatory bowel disease: Individualizing the use of biologics and small molecule therapies |
title_full_unstemmed | Precision medicine in inflammatory bowel disease: Individualizing the use of biologics and small molecule therapies |
title_short | Precision medicine in inflammatory bowel disease: Individualizing the use of biologics and small molecule therapies |
title_sort | precision medicine in inflammatory bowel disease: individualizing the use of biologics and small molecule therapies |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037250/ https://www.ncbi.nlm.nih.gov/pubmed/36970587 http://dx.doi.org/10.3748/wjg.v29.i10.1539 |
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