Joseph D. Feuerstein and Adam S. Cheifetz Anti-tumor necrosis factor-α (anti-TNF) agents are frequently used in the treatment of inflammatory bowel disease (IBD). Currently, selleck screening library there are 4 anti-TNF therapies that are Food and Drug Administration–approved for moderate to severe IBD: infliximab, adalimumab, golimumab, and certolizumab pegol. For most noninfectious, nonmalignant adverse events, cessation of anti-TNF therapy typically leads to improvement

or resolution of drug-induced complications. In this article, the current knowledge regarding the noninfectious and nonmalignant toxicities associated with anti-TNF agents is summarized. Kirk Lin and Uma Mahadevan Biologic therapies, including the anti–tumor necrosis factor-α and cell adhesion molecule selleckchem inhibitor drugs, have revolutionized the treatment of moderate-to-severe inflammatory bowel disease. Since the introduction of anti–tumor necrosis factor therapies, the strategy of empiric dose-escalation, either increasing the dose or frequency of administration, has been used to recapture clinical response in inflammatory bowel disease. Disparate clinical outcomes have been linked to serum drug and antidrug antibody levels. Therapeutic drug monitoring has emerged as a framework for understanding and responding to the variability in clinical response and remission. Masayuki Saruta and

Konstantinos A. Papadakis Lymphocyte homing antagonists represent promising therapeutic agents for the treatment of idiopathic inflammatory bowel disease (IBD). Several critical molecules involved in the recruitment of inflammatory cells in the intestine, including Rutecarpine integrins and chemokine receptors, have been successfully targeted for the treatment of IBD. These agents have shown great promise for the induction and maintenance of remission for both Crohn disease and ulcerative colitis. This article discusses currently approved prototypic agents for the treatment of IBD (natalizumab, anti-α4 integrin; vedolizumab, anti-α4β7 integrin), and several other agents in the same class

currently under development. Brigid S. Boland, William J. Sandborn, and John T. Chang Janus kinase (JAK) inhibitors have emerged as a novel orally administered small-molecule therapy for the treatment of ulcerative colitis and possibly Crohn disease. These molecules are designed to selectively target the activity of specific JAKs and to offer a targeted mechanism of action without risk of immunogenicity. Based on data from clinical trials in rheumatoid arthritis and phase 2 studies in inflammatory bowel disease, tofacitinib and other JAK inhibitors are likely to become a new form of medical therapy for the treatment of inflammatory bowel disease. Yvette Leung and Remo Panaccione Despite the success of antitumor necrosis factor (TNF) therapy in Crohn’s disease, there remains a need for biologic therapy that targets other immune pathways of disease.