Pharmacologic therapy for inflammatory bowel disease refractory to steroids

• Main Authors: Martínez-Montiel MP, Casis-Herce B, Gómez-Gómez GJ, Masedo-González A, Yela-San Bernardino C, Piedracoba C, Castellano-Tortajada G
• Format: Article
• Language: English
• Published: Dove Medical Press 2015-08-01
• Series: Clinical and Experimental Gastroenterology
• Online Access: http://www.dovepress.com/pharmacologic-therapy-for-inflammatory-bowel-disease-refractory-to-ste-peer-reviewed-article-CEG

MP Martínez-Montiel, B Casis-Herce , GJ Gómez-Gómez, A Masedo-González, C Yela-San Bernardino, C Piedracoba, G Castellano-Tortajada Division of Gastroenterology, Hospital 12 de Octubre, Madrid, SpainAbstract: Although corticosteroids are an effective treatment for induction of remission in inflammatory bowel disease (IBD), many patients are dependent on or refractory to corticosteroids. This review is based on scrutinizing current literature with emphasis on randomized controlled trials, meta-analyses, and Cochrane reviews on the management of IBD refractory to corticosteroids. Based on this evidence, we propose algorithms and optimization strategies for use of immunomodulator and biologic therapy in IBD refractory to corticosteroids.Keywords: immunomodulators, anti-tumor necrosis factor alpha, Crohn's disease, ulcerative colitis, drug levels, treatment optimization