Reinglas J, Gonczi L, Kurt Z, Bessissow T, Lakatos PL. Positioning of old and new biologicals and small molecules in the treatment of inflammatory bowel diseases. World J Gastroenterol 2018; 24(32): 3567-3582 [PMID: 30166855 DOI: 10.3748/wjg.v24.i32.3567]
Corresponding Author of This Article
Peter L Lakatos, DSc, MD, PhD, Professor, Division of Gastroenterology, Montreal General Hospital C7-200, McGill University Health Center, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada. kislakpet99@gmail.com
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Gastroenterology & Hepatology
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Review
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Reinglas J, Gonczi L, Kurt Z, Bessissow T, Lakatos PL. Positioning of old and new biologicals and small molecules in the treatment of inflammatory bowel diseases. World J Gastroenterol 2018; 24(32): 3567-3582 [PMID: 30166855 DOI: 10.3748/wjg.v24.i32.3567]
World J Gastroenterol. Aug 28, 2018; 24(32): 3567-3582 Published online Aug 28, 2018. doi: 10.3748/wjg.v24.i32.3567
Positioning of old and new biologicals and small molecules in the treatment of inflammatory bowel diseases
Jason Reinglas, Lorant Gonczi, Zsuzsanna Kurt, Talat Bessissow, Peter L Lakatos
Jason Reinglas, Talat Bessissow, Peter L Lakatos, Department of Gastroenterology, McGill University Health Center, Montreal, Québec H4A 3J1, Canada
Lorant Gonczi, Zsuzsanna Kurt, Peter L Lakatos, First Department of Medicine, Semmelweis University, H-1083, Budapest, Koranyi S. 2A, Hungary
Author contributions: All the authors contributed to the writing of the manuscript.
Conflict-of-interest statement: Bessissow T has been a speaker and/or advisory board member for: AbbVie, Janssen, Takeda, Pfizer, Merck, Shire, Ferring and Pendopharm and has received unrestricted research grant from: AbbVie, Janssen, Pentax and Echosense; Lakatos PL has been a speaker and/or advisory board member: AbbVie, Celltrion, Falk Pharma GmbH, Ferring, Genetech, Jansen, Kyowa Hakko Kirin Pharma, Mitsubishi Tanabe Pharma Corporation, MSD, Otsuka Pharma, Pharmacosmos, Pfizer, Roche, Shire and Takeda and has received unrestricted research grant: AbbVie, MSD and Pfizer. There are no conflicts of interest to report from other authors
Correspondence to: Peter L Lakatos, DSc, MD, PhD, Professor, Division of Gastroenterology, Montreal General Hospital C7-200, McGill University Health Center, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada. kislakpet99@gmail.com
Telephone: +36-1-2100278 Fax: +36-1-3130250
Received: March 29, 2018 Peer-review started: March 29, 2018 First decision: April 26, 2018 Revised: May 9, 2018 Accepted: June 25, 2018 Article in press: June 25, 2018 Published online: August 28, 2018 Processing time: 151 Days and 7.8 Hours
Core Tip
Core tip: Anti-tumor necrosis factor therapy should be considered as first-line therapy in patients with complicated Crohn’s disease and in acute-severe ulcerative colitis. Beyond these specific circumstances, the positioning of novel biologics and small molecules depends on the patient’s medical history, preference and disease phenotype. The efficacy and safety of using immunomodulatory therapy can be enhanced by adhering to therapeutic algorithms and using a ‘treat-to-target’ approach. The risks for adverse events due to poor disease control outweigh the risks associated with early aggressive therapy. In the setting of clinical and biochemical remission, following at least 6 mo of combined immunosuppressive therapy, consideration can be made to withdrawing thiopurine therapy in the correct patient with close follow-up.
