Open AccessRecent advances in monoclonal antibody therapy in IBD: practical issues
Author(s) -
Aravind Gokul Tamilarasan,
Georgina Cunningham,
Peter Irving,
Mark A Samaan
Publication year - 2019
Publication title -
frontline gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.919
H-Index - 13
eISSN - 2041-4145
pISSN - 2041-4137
DOI - 10.1136/flgastro-2018-101054
Subject(s) - medicine , vedolizumab , biosimilar , ustekinumab , monoclonal antibody , intensive care medicine , disease , monoclonal antibody therapy , drug , crohn's disease , inflammatory bowel disease , immunology , pharmacology , antibody , adalimumab
The advent of monoclonal antibody therapies has revolutionised inflammatory bowel disease (IBD) treatment and delivered great benefits to patients. The optimal use of this class of drugs requires careful management and a clear understanding of their properties. In this review article, we consider how to maximise the benefit of our most novel biological agents, vedolizumab and ustekinumab. For each agent, we consider practical aspects including dose flexibility, evidence for use in combination with a conventional immunomodulator and the potential role of therapeutic drug monitoring. We also address positioning of the various mechanisms and agents in treatment algorithms as well as important aspects of managing patients receiving monoclonal antibodies, such as disease reassessment. Finally, we look ahead to the future of monoclonal antibodies, where not only have biosimilars increased the number of agents available but there are also a range of novel mechanisms currently in late phase clinical trials.