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Related Concept Videos

Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
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Drugs for Treatment of Ulcerative Colitis in IBD01:29

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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Biologic agents for IBD: practical insights.

Silvio Danese1, Lucine Vuitton2, Laurent Peyrin-Biroulet3

  • 1Department of Gastroenterology, IBD Centre, Humanitas Research Hospital, Via A. Manzoni 56, 20089 Rozzano, Milan, Italy.

Nature Reviews. Gastroenterology & Hepatology
|August 19, 2015
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Summary
This summary is machine-generated.

Choosing biologic agents for inflammatory bowel disease (IBD) requires considering effectiveness, safety, cost, and patient preference. Head-to-head trials are needed to guide optimal treatment selection and switching strategies.

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Area of Science:

  • Gastroenterology
  • Immunology
  • Pharmacology

Background:

  • Six biologic agents, including anti-TNF and anti-integrin therapies, are approved for inflammatory bowel disease (IBD).
  • Treatment selection for refractory IBD is complex, necessitating careful consideration of multiple factors.

Purpose of the Study:

  • To provide practical insights into the use of biologic agents for IBD management.
  • To highlight key parameters influencing treatment decisions in IBD.

Main Methods:

  • Review of current literature and approved biologic agents for IBD.
  • Discussion of factors influencing clinical decision-making for biologic therapy selection.

Main Results:

  • Current treatment choices involve balancing comparative effectiveness, long-term safety, drug availability, guidelines, cost, and patient preferences.
  • Head-to-head trials are crucial for guiding first-line biologic choices and optimizing switching strategies after loss of response.

Conclusions:

  • Physicians must consider a range of factors when selecting biologic agents for IBD.
  • Future treatment algorithms will likely evolve with new drug approvals and increased biosimilar utilization.