J Korean Med Assoc.  2021 Sep;64(9):605-613. 10.5124/jkma.2021.64.9.605.

Treatment of inflammatory bowel diseases: focusing on biologic agents and new therapies

• Song HY
• Seo GS

• KMID: 2520191
• DOI: http://doi.org/10.5124/jkma.2021.64.9.605

Abstract

Background
The treatment of inflammatory bowel diseases has evolved with the development of anti-tumor necrosis factor agents. Despite the long-term effectiveness, many patients experience primary non-response, secondary loss of response, or intolerance. Therefore, the development of new drugs that act on different inflammatory pathways has become necessary. This review focuses on biologic agents and new therapies for the treatment of inflammatory bowel diseases.
Current Concepts
Vedolizumab, a gut-selective agent that targets α4β7 integrin is effective in both ulcerative colitis and Crohn’s disease. Ustekinumab is a monoclonal antibody that binds to p40 subunit of interleukin-12/interleukin-23. Ustekinumab is available for the treatment of Crohn’s disease and ulcerative colitis. Tofacitinib is the first Janus kinase inhibitor approved for the treatment of ulcerative colitis. The advantage of tofacitinib is an oral prescription medicine and has rapid action.
Discussion and Conclusion
Since vedolizumab, ustekinumab and tofacitinib are effective agents for the treatment of inflammatory bowel diseases, positioning of old and new biologic agents and small molecules should be determined. The safety and efficacy of novel and emerging drugs needs to be evaluated in patients with inflammatory bowel disease.

Keyword

Inflammatory bowel diseases; Biologic agents; Vedolizumab; Ustekinumab; Tofacitinib; 염증장질환; 생물학적제제; 베돌리주맙; 유스테키누맙; 토파시티닙