Managing Risks with Biologics

被引：29
作者：
Click B. [1 ]
Regueiro M. [1 ]
机构：
[1] Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, OH
来源：
Current Gastroenterology Reports | 2019年 / 21卷 / 1期
关键词：
Biologics; Crohn’s disease; Infection; Safety; Ulcerative colitis;
D O I：
10.1007/s11894-019-0669-6
中图分类号：
学科分类号：
摘要：
Purpose of Review: With a rapidly evolving complement of advanced targeted therapies in inflammatory bowel disease, additional safety and side effect concerns emerge. It is the purpose of this review to consider various risks with biologic therapies in inflammatory bowel disease and discuss mitigating strategies. Recent Findings: Two recently approved monoclonal antibodies (vedolizumab and ustekinumab) and a Janus kinase inhibitor small molecule (tofacitnib) have introduced a number of novel safety and risk considerations. We review the clinical trial and real-world safety data to date on these agents as well as review new data and considerations with anti-tumor necrosis factor agents. New vaccines for varicella zoster virus, hepatitis B virus, and high-dose influenza have been studied, and we discuss the clinical importance of these findings. Lastly, we make management recommendations in the event of particular side effects or complications. Summary: Understanding the risks of new agents in inflammatory bowel disease, potential mitigating strategies, and management considerations is important to achieving and maintaining clinical outcomes in IBD patients. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
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