Positioning biologics in the management of moderate to severe Crohn's disease
| Autor: | Fadi H. Mourad, Jana G. Hashash |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Crohn's disease business.industry Gastroenterology MEDLINE Disease medicine.disease Infliximab law.invention Vedolizumab 03 medical and health sciences Therapeutic approach 0302 clinical medicine Randomized controlled trial law 030220 oncology & carcinogenesis Ustekinumab medicine 030211 gastroenterology & hepatology Intensive care medicine business medicine.drug |
| Zdroj: | Current Opinion in Gastroenterology. 37:351-356 |
| ISSN: | 1531-7056 0267-1379 |
| DOI: | 10.1097/mog.0000000000000735 |
| Popis: | Purpose of review Since there is a lack of head-to-head randomized controlled trials, little direction is provided from guidelines on the positioning of biologics for the treatment of Crohn's disease (CD). This review utilizes comparative effectiveness and safety results from real-world data and network meta-analyses to inform clinical practice for positioning of biological therapies in the treatment of moderate-to-severe CD. Recent findings We summarize the results of studies pertaining to the identification of predictors for response to biologics in CD. Recently published studies about the management of moderate-to-severe CD are discussed and a positioning algorithm is proposed for the therapeutic approach of these patients. Summary Different classes of biologics are comparable with regards to safety and almost similar in effectiveness in the management of CD. There are certain clinical scenarios in which one biologic is more effective than another. For instance, patients with a more aggressive disease phenotype such as fistulizing disease would benefit from infliximab over other biologics, whereas in older patients at a higher risk for infectious complications, it may be more appropriate to use ustekinumab or vedolizumab over the anti-tumor necrosis factor (TNF) agents. More data pertaining to identifying predictors of response to the different available therapies and head-to-head comparison trials are needed to personalize our therapeutic approach of CD patients. |
| Databáze: | OpenAIRE |
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