First Department of Medicine, Centro per lo Studio e la Cura delle Malattie Infiammatorie Croniche intestinali, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy.
Intern Emerg Med. 2011 Oct;6 Suppl 1:17-27. doi: 10.1007/s11739-011-0673-9.
Inflammatory bowel diseases (IBD), namely Crohn's disease and ulcerative colitis, are burdened by high medical costs which are mostly dependent on hospital inpatient treatment. New biologic therapies, which target specific cytokines in the inflammatory cascade leading to the intestinal lesions, including tumor necrosis factor (TNF)-α, have revolutionized the management of IBD by offering a therapeutic chance to patients in whom conventional therapies failed. However, the relatively high costs of biologic drugs, together with their potential toxicity due to infections and malignancies, have led to debate regarding their indiscriminate use in IBD patients. The purpose of this review is to deal with the optimal use and cost-effectiveness of the two main monoclonal anti-TNF-α agents currently used in the management of IBD patients, i.e. the chimeric human/murine antibody infliximab and the fully human antibody adalimumab.
炎症性肠病（IBD），即克罗恩病和溃疡性结肠炎，其医疗费用负担沉重，主要依赖于医院住院治疗。新型生物疗法针对导致肠道病变的炎症级联反应中的特定细胞因子，如肿瘤坏死因子（TNF）-α，为那些传统疗法失败的患者提供了治疗机会，从而彻底改变了 IBD 的治疗模式。然而，生物药物相对较高的成本，以及由于感染和恶性肿瘤而导致的潜在毒性，导致人们对其在 IBD 患者中的无差别使用产生了争议。本文旨在探讨目前用于 IBD 患者治疗的两种主要的单克隆抗 TNF-α 药物，即嵌合人/鼠抗体英夫利昔单抗和完全人源抗体阿达木单抗的最佳使用方法和成本效益。
