Drug Management of Inflammatory Bowel Disease (IBD): A Narrative Review

The exact underlying etiopathogenesis of inflammatory bowel disease (IBD) remains unclear. Conventionally, autoimmune mechanisms have been linked with IBD, and thus various immunomodulatory or anti-inflammatory drugs have proven useful. The understanding of the complex gut mucosal immune system and the trafficking of leukocytes toward the intestine from lymphoid organs has allowed us to use molecular drugs that may target specific pathways, like the Janus kinase (JAK) pathway, phosphodiesterase, interleukins (IL)-12, 23, and adhesion molecules such as selectins. These agents have brought about a drastic change in the management strategy of IBD. Since many patients may not improve on conventional therapy, newer treatments are tried, which show better efficacy with fewer side effects. The present review highlights the concepts of newer therapeutic drugs, their interaction with host microbiome and gut-brain axis, and the new targets in the autoimmune phenomena, thereby providing a promising treatment for a better management of IBD in the present and future times.