Pharmacotherapeutic options in inflammatory bowel disease: an update

Chronic inflammatory bowel disease (IBD) refers to two diseases: Crohn's disease (CD) and ulcerative colitis (UC). The etiology of IBD remains unknown. The understanding of the pathogenesis has expanded greatly over the last decade. The combination of genetic risk factors, abnormalities in the immune system, vascular and neural factors, and random environmental factors may all play an important role. Most treatments currently in use have multiple action. The choice of appropriate medical treatment is determined by the status (inductive or maintenance therapy) and severity of the disease and the potential for toxicity. Despite the variety of medical therapies available for the treatment of IBD, none is ideal. Ongoing research into the well-established drugs, as well as novel agents with more precise targets, may contribute to an optimal therapy of IBD in the near future. In this paper the current (5-aminosalicylates, glucocorticosteroids, thioguanine derivatives, methotrexate, cyclosporin and infliximab) as well as some of the new (mycophenolate mofetil and thalidomide) therapeutic options are reviewed.