Choosing the right biologic for complications of inflammatory bowel disease

ABSTRACT

Introduction

Inflammatory bowel disease (IBD) is a chronic, inflammatory condition that involves the intestinal tract, and can also present with extra-intestinal manifestations (EIM). Choosing the right treatment for IBD is often nuanced and decisions can become even more complicated when a patient presents with or develops a complication of the disease.

Areas covered

We aimed to provide an overview of the most common complications of IBD, specifically intestinal and EIM, and summarize the data regarding biologic therapy for treatment of these conditions. A comprehensive literature review was performed using PubMed and Medline databases to identify studies published in the English language relevant to the broad scope of this review.

Expert opinion

There are still significant gaps in our understanding of the pathophysiology of IBD and its treatment, especially in regards to complications of the disease. As novel therapies continue to emerge for treatment of IBD, we feel concurrent examination of their impact on intestinal complications and EIM of IBD is important and should be a priority of future research.

KEYWORDS:

• Inflammatory bowel disease
• ulcerative colitis
• Crohn’s disease
• extra-intestinal manifestations
• biologic therapy
• anti-TNF therapy
• vedolizumab
• ustekinumab
• tofacitinib

Declaration of interest

ASC reports consultancy fees from Janssen, Abbvie, Artugen, ProciseDx, Prometheus, Arena, Grifols, Bacainn, Bristol Myers Squibb; and research support from Inform Diagnostics. K.P. reports lecture fees from Mitsubishi Tanabe Pharma and Physicians Education Resource LLC; consultancy fee from Prometheus Laboratories Inc; and scientific advisory board fees from ProciseDx Inc and Scipher Medicine Corporation. The remaining author declares no conflict of interest.

Financial support and sponsorship

None