Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Gut Liver. 2019 Nov 15;13(6):604-616. doi: 10.5009/gnl19019.
New therapeutic strategies in inflammatory bowel disease (IBD) have shifted from symptom control towards treat-to-target algorithms in order to optimize treatment results. The treatment of IBD has evolved with the development of tumor necrosis factor-α inhibitors beyond the conventional therapies. In spite of their long-term effectiveness, many patients do not respond to or cannot sustain treatment with these drugs, which have various side effects. Therefore, the development of new drugs targeting specific pathways in the pathogenesis of IBD has become necessary. Some novel biologics and small molecule drugs have shown potential in IBD clinical trials, providing safe and effective results. In addition, clinicians are now trying to target the dysbiotic microbiome of patients with IBD using fecal microbiota transplantation. New tools such as stem cells have also been developed. The available therapeutic options for IBD are expanding rapidly. In the next few years, physicians will face an unprecedented number of options when choosing the best treatments for patients with IBD. This review provides an overview of recent advances in IBD treatment options.
炎症性肠病(IBD)的新治疗策略已经从症状控制转向针对目标的治疗算法,以优化治疗结果。随着肿瘤坏死因子-α抑制剂的发展,IBD 的治疗已经超越了传统疗法。尽管这些药物具有长期疗效,但许多患者对这些药物没有反应或无法维持治疗,而且这些药物有各种副作用。因此,开发针对 IBD 发病机制中特定途径的新药变得必要。一些新型生物制剂和小分子药物在 IBD 临床试验中显示出了潜力,提供了安全有效的结果。此外,临床医生现在正试图使用粪便微生物群移植来靶向 IBD 患者的失调微生物组。干细胞等新工具也已被开发出来。IBD 的治疗选择正在迅速扩大。在未来几年,医生在为 IBD 患者选择最佳治疗方法时将面临前所未有的选择。本文综述了 IBD 治疗选择的最新进展。