Recent developments in inflammatory bowel disease therapy

Inflammatory bowel disease (IBD) is a collective term used to encompass two histologically distinct disorders of the gastrointestinal tract, ulcerative colitis and Crohn's disease. Although the exact aetiology of these diseases remains elusive, environmental, genetic and immunological factors appear to have the strongest base for causing the disease. Traditional medical therapy includes corticosteroids, congeners of 5-aminosalicylic acid and immune modulators, such as azathioprine, methotrexate and cyclosporine. The majority of patients can be managed with these therapies; however, IBD does relapse, suggesting that these therapies do not alter the course of disease. An explosion of information and new data has generated a host of pharmacological and immunological strategies to treat IBD. This comprehensive review examines the most recent patented claims that will likely benefit treatment and management of IBD. While some of the claims are not fastidious, a few of the newer claims have tremendous potential in abrogating inflammation in IBD. Novel compounds of particular interest include anticytokine and anti-adhesion strategies which are already showing great promise in human compassionate, open label and controlled trials. It is unfortunate that some exceptional compounds reviewed here, which have great potential for IBD therapy, have not been tested in vivo. Thus, it is implicit that these anticytokine agents, and agents that prevent the adhesion and diapedesis of mediators cells, are tested in experimental models of intestinal inflammation to ensure that the claims are substantiated and safe to use in humans. The authors are encouraged that the pharmaceutical industry is capitalising on the most recent bench-side discoveries in the hope that they can take their compounds to the bed-side to improve the quality of life for patients suffering from these diseases.