期刊
INFLAMMATORY BOWEL DISEASES
卷 23, 期 8, 页码 301-315出版社
OXFORD UNIV PRESS INC
DOI: 10.1097/MIB.0000000000001199
关键词
inflammatory bowel disease; Crohn's disease; ulcerative colitis; azathioprine; mercaptopurine; infliximab; adalimumab; certolizumab pegol; golimumab; natalizumab; vedolizumab; ustekinumab; methotrexate; contraindications
资金
- Department of Defense [PR141774]
- Crohn's and Colitis Foundation of America Career Development Award
- National Institutes of Health Ruth L. Kirschstein National Research Service Award [5 T32 DK 83251, 5 T32 DK 83252, 5 T32 DK 83253, 5 T32 DK 83254, 5 T32 DK 83255]
- Lansing C. Hoskins Education Research Fund Award
- AbbVie
- UCB
- Janssen
- Takeda
- Amgen
- Genentech
- Gilead
- Receptos
- Celgene
- Seres Therapeutics
- Robarts Clinic Trials
- MedImmune
- Pfizer
Ulcerative colitis and Crohn's disease are chronic inflammatory bowel diseases for which there are no cures. These diseases are immuno-pathogenic, and medical treatment is centered on the temperance of a dysregulated immune response to allow mucosal healing and prevent the sequelae of fistulation and stenosis. Accordingly, the armamentarium of medications, which has expanded immensely in recent history, is not without significant infectious and neoplastic risks. Many of these untoward effects can be mitigated by screening and avoidance of contraindicated medications. This review seeks to highlight the cautions for use of immunomodulators, anticytokine, and alpha 4-integrin antagonists. The potential adverse events are further complicated by substantial heterogeneity in disease phenotype in the inflammatory bowel disease population. Large patient registries and databases provide considerable experience and knowledge to calculate the incidence of safety outcomes. To identify rarer outcomes after prolonged therapy, more prospective studies and continued adverse event reporting will aid safe application and minimize potential harms.
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