First-Line Biologics or Small Molecules in Inflammatory Bowel Disease: a Practical Guide for the Clinician.
Curr Gastroenterol Rep
; 22(2): 7, 2020 Jan 30.
Article
em En
| MEDLINE
| ID: mdl-32002688
ABSTRACT
PURPOSE OF REVIEW Treating moderate-to-severe inflammatory bowel disease has become increasingly complex as the array of available biologics increases. Moreover, tofacitinib, the first small molecule approved for IBD, is available for use in ulcerative colitis. Choosing the right biologic, for the right patient, at the right time, can be a confusing and daunting task for clinicians. RECENT FINDINGS:
In this review, we summarize the evidence for first-line use of the available biologics by disease state. Special circumstances for consideration including rapidity of action, safety, comparative effectiveness, postoperative Crohn's disease, fertility and pregnancy, and extraintestinal manifestations are discussed. In the moderate-to-severe UC patient, vedolizumab and infliximab are preferred first-line options. In the moderate-to-severe CD patient with a penetrating phenotype or with multiple EIMs, infliximab or adalimumab are the preferred first-line agents. In the moderate-to-severe CD patient with an inflammatory phenotype, anti-TNF, vedolizumab, and ustekinumab are all reasonable options.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Produtos Biológicos
/
Doenças Inflamatórias Intestinais
Tipo de estudo:
Guideline
Limite:
Humans
Idioma:
En
Revista:
Curr Gastroenterol Rep
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos