Biological Therapy: The Assess of Clinical Efficacy and Safety in Immune Mediated Inflammatory Diseases

Dear Colleagues,

Anti-tumor necrosis factor (TNF) therapy—namely, infliximab, adalimumab, certolizumab pegol, and golimumab—is very effective for treating moderate-to-severe inflammatory bowel disease (IBD), with a good safety profile. Anti-TNF therapy has also been used to treat pouchitis following ileal pouch-anal anastomosis after restorative proctocolectomy and to prevent post-operative recurrence following ileocolonic resection for Crohn’s disease with good results. Nevertheless, up to one-third of patients show no clinical benefit following induction and up to 50% lose response over time. Both these unwanted outcomes can be largely explained by inadequate drug concentrations and frequently by the development of anti-drug antibodies—so-called immunogenicity. Reactive therapeutic drug monitoring (TDM) has rationalized the management of loss of response, and is more cost-effective than empirical treatment optimization based only on symptoms. Recent data suggest that proactive TDM and dosing to a therapeutic drug concentration in patients in clinical remission is associated with improved long-term outcomes. The aim of this Special Issue is to highlight recent advances in the context of efficacy and safety of anti-TNF therapy in IBD.

Prof. Dr. Konstantinos Papamichael
Guest Editor

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