Tamilarasan Aravind Gokul, Cunningham Georgina, Irving Peter M, Samaan Mark A
IBD Centre, Guy's and St Thomas' NHS Trust, London, UK.
Frontline Gastroenterol. 2019 Oct;10(4):409-416. doi: 10.1136/flgastro-2018-101054. Epub 2019 Jan 18.
The advent of monoclonal antibody therapies has revolutionised inflammatory bowel disease (IBD) treatment and delivered great benefits to patients. The optimal use of this class of drugs requires careful management and a clear understanding of their properties. In this review article, we consider how to maximise the benefit of our most novel biological agents, vedolizumab and ustekinumab. For each agent, we consider practical aspects including dose flexibility, evidence for use in combination with a conventional immunomodulator and the potential role of therapeutic drug monitoring. We also address positioning of the various mechanisms and agents in treatment algorithms as well as important aspects of managing patients receiving monoclonal antibodies, such as disease reassessment. Finally, we look ahead to the future of monoclonal antibodies, where not only have biosimilars increased the number of agents available but there are also a range of novel mechanisms currently in late phase clinical trials.
单克隆抗体疗法的出现彻底改变了炎症性肠病（IBD）的治疗方式，并为患者带来了巨大益处。最佳使用这类药物需要谨慎管理并清楚了解其特性。在这篇综述文章中，我们探讨如何最大化我们最新的生物制剂维多珠单抗和乌司奴单抗的益处。对于每种药物，我们考虑实际方面，包括剂量灵活性、与传统免疫调节剂联合使用的证据以及治疗药物监测的潜在作用。我们还讨论了各种机制和药物在治疗方案中的定位，以及管理接受单克隆抗体治疗患者的重要方面，如疾病重新评估。最后，我们展望单克隆抗体的未来，不仅生物类似药增加了可用药物的数量，而且目前还有一系列新机制正处于晚期临床试验阶段。
