Real-World Success of Biologic Therapy in IBD: No More Reasons to Be Anti Antibody

Excerpt

Tumor necrosis factor-α antibodies (anti-TNFs), termed “biologics,” have revolutionized the medical management of moderate–severe inflammatory bowel disease. Randomized control trials have reported the efficacy of these drugs in the induction and maintenance of remission in the inflammatory bowel diseases (IBD): Crohn’s disease and ulcerative colitis. Published data regarding efficacy and safety of the drugs are usually generated from randomized control trials (RCTs). Nevertheless, results of RCTs may not always be replicated in routine clinical practice, given the stringent inclusion and exclusion criteria affecting patient selection combined with rigorous analytic methodology [1]. These exclusion criteria often relate to prior use of steroids and immunomodulators, the presence of TNF antibodies, past surgical history, coexisting medication use, and the presence of stricturing/penetrating Crohn’s disease. The RCT-enrolled patient therefore may bear little resemblance to the patient in front of you in clinical practice; hence, good-quality “real-world” data are clearly useful to guide in IBD therapy in clinical practice [2]. …