Annals of Colorectal Research

Published by: Kowsar

Biologics for Ulcerative Colitis: Status of the Art and General Considerations

Giovanni C Actis 1 , *
Author Information
1 The Medical Center Practice Office, Torino, Italy
Article information
  • Annals of Colorectal Research: March 2017, 5 (1-2); e42868
  • Published Online: December 27, 2016
  • Article Type: Review Article
  • Received: October 7, 2016
  • Revised: December 14, 2016
  • Accepted: December 22, 2016
  • DOI: 10.5812/acr.42868

To Cite: Actis G C. Biologics for Ulcerative Colitis: Status of the Art and General Considerations, Ann Colorectal Res. 2017 ; 5(1-2):e42868. doi: 10.5812/acr.42868.

Copyright © 2017, Colorectal Research Center and Health Policy Research Center of Shiraz University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Data Acquisition
3. Results
4. The Highlighted Results, Targeted discussion, and Recommendations
5. Conclusions
6. The Future
  • 1. Baumgart DC, Sandborn WJ. Inflammatory bowel disease: clinical aspects and established and evolving therapies. Lancet. 2007; 369(9573): 1641-57[DOI][PubMed]
  • 2. Kohl J, Gessner JE. On the role of complement and Fc gamma-receptors in the Arthus reaction. Mol Immunol. 1999; 36(13-14): 893-903[PubMed]
  • 3. Rubin GP, Hungin AP, Kelly PJ, Ling J. Inflammatory bowel disease: epidemiology and management in an English general practice population. Aliment Pharmacol Ther. 2000; 14(12): 1553-9[PubMed]
  • 4. Roda G, Sartini A, Zambon E, Calafiore A, Marocchi M, Caponi A, et al. Intestinal epithelial cells in inflammatory bowel diseases. World J Gastroenterol. 2010; 16(34): 4264-71[PubMed]
  • 5. Faubion WJ, Loftus EJ, Harmsen WS, Zinsmeister AR, Sandborn WJ. The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study. Gastroenterology. 2001; 121(2): 255-60[PubMed]
  • 6. Sachar DB. Management of acute, severe ulcerative colitis. J Dig Dis. 2012; 13(2): 65-8[DOI][PubMed]
  • 7. Egan LJ, Mays DC, Huntoon CJ, Bell MP, Pike MG, Sandborn WJ, et al. Inhibition of interleukin-1-stimulated NF-kappaB RelA/p65 phosphorylation by mesalamine is accompanied by decreased transcriptional activity. J Biol Chem. 1999; 274(37): 26448-53[PubMed]
  • 8. Sutherland L, Macdonald JK. Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2006; (2)[DOI][PubMed]
  • 9. Cheifetz AS, Stern J, Garud S, Goldstein E, Malter L, Moss AC, et al. Cyclosporine is safe and effective in patients with severe ulcerative colitis. J Clin Gastroenterol. 2011; 45(2): 107-12[DOI][PubMed]
  • 10. Actis GC, Fadda M, David E, Sapino A. Colectomy rate in steroid-refractory colitis initially responsive to cyclosporin: a long-term retrospective cohort study. BMC Gastroenterol. 2007; 7: 13[DOI][PubMed]
  • 11. Shirai T, Yamaguchi H, Ito H, Todd CW, Wallace RB. Cloning and expression in Escherichia coli of the gene for human tumour necrosis factor. Nature. 1985; 313(6005): 803-6[PubMed]
  • 12. Hadziselimovic F, Emmons LR, Gallati H. Soluble tumour necrosis factor receptors p55 and p75 in the urine monitor disease activity and the efficacy of treatment of inflammatory bowel disease. Gut. 1995; 37(2): 260-3[PubMed]
  • 13. Lushbaugh C, Humason G, Clapp N. Histology of colitis: Saguinus oedipus oedipus and other marmosets. Dig Dis Sci. 1985; 30(12 Suppl): 45S-51S[PubMed]
  • 14. Kornbluth A. Infliximab approved for use in Crohn's disease: a report on the FDA GI Advisory Committee conference. Inflamm Bowel Dis. 1998; 4(4): 328-9[PubMed]
  • 15. Rutgeerts P, Sandborn WJ, Feagan BG, Reinisch W, Olson A, Johanns J, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2005; 353(23): 2462-76[DOI][PubMed]
  • 16. Gustavsson A, Jarnerot G, Hertervig E, Friis-Liby I, Blomquist L, Karlen P, et al. Clinical trial: colectomy after rescue therapy in ulcerative colitis - 3-year follow-up of the Swedish-Danish controlled infliximab study. Aliment Pharmacol Ther. 2010; 32(8): 984-9[DOI][PubMed]
  • 17. Lees CW, Heys D, Ho GT, Noble CL, Shand AG, Mowat C, et al. A retrospective analysis of the efficacy and safety of infliximab as rescue therapy in acute severe ulcerative colitis. Aliment Pharmacol Ther. 2007; 26(3): 411-9[DOI][PubMed]
  • 18. Regueiro M, Curtis J, Plevy S. Infliximab for hospitalized patients with severe ulcerative colitis. J Clin Gastroenterol. 2006; 40(6): 476-81[PubMed]
  • 19. Jakobovits SL, Jewell DP, Travis SP. Infliximab for the treatment of ulcerative colitis: outcomes in Oxford from 2000 to 2006. Aliment Pharmacol Ther. 2007; 25(9): 1055-60[DOI][PubMed]
  • 20. Ferrante M, Vermeire S, Katsanos KH, Noman M, Van Assche G, Schnitzler F, et al. Predictors of early response to infliximab in patients with ulcerative colitis. Inflamm Bowel Dis. 2007; 13(2): 123-8[DOI][PubMed]
  • 21. Farkas K, Lakatos PL, Szucs M, Pallagi-Kunstar E, Balint A, Nagy F, et al. Frequency and prognostic role of mucosal healing in patients with Crohn's disease and ulcerative colitis after one-year of biological therapy. World J Gastroenterol. 2014; 20(11): 2995-3001[DOI][PubMed]
  • 22. Renna S, Cottone M, Orlando A. Optimization of the treatment with immunosuppressants and biologics in inflammatory bowel disease. World J Gastroenterol. 2014; 20(29): 9675-90[DOI][PubMed]
  • 23. Vermeire S, Noman M, Van Assche G, Baert F, D'Haens G, Rutgeerts P. Effectiveness of concomitant immunosuppressive therapy in suppressing the formation of antibodies to infliximab in Crohn's disease. Gut. 2007; 56(9): 1226-31[DOI][PubMed]
  • 24. Rutgeerts P, Feagan BG, Lichtenstein GR, Mayer LF, Schreiber S, Colombel JF, et al. Comparison of scheduled and episodic treatment strategies of infliximab in Crohn's disease. Gastroenterology. 2004; 126(2): 402-13[PubMed]
  • 25. Feagan BG, Rutgeerts P, Sands BE, Hanauer S, Colombel JF, Sandborn WJ, et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2013; 369(8): 699-710[DOI][PubMed]
  • 26. Orlando A, Armuzzi A, Papi C, Annese V, Ardizzone S, Biancone L, et al. The Italian Society of Gastroenterology (SIGE) and the Italian Group for the study of Inflammatory Bowel Disease (IG-IBD) Clinical Practice Guidelines: The use of tumor necrosis factor-alpha antagonist therapy in inflammatory bowel disease. Dig Liver Dis. 2011; 43(1): 1-20[DOI][PubMed]
  • 27. Rahier JF, Magro F, Abreu C, Armuzzi A, Ben-Horin S, Chowers Y, et al. Second European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. J Crohns Colitis. 2014; 8(6): 443-68[DOI][PubMed]
  • 28. Dignass A, Eliakim R, Magro F, Maaser C, Chowers Y, Geboes K, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1: definitions and diagnosis. J Crohns Colitis. 2012; 6(10): 965-90[DOI][PubMed]
  • 29. D'Haens GR. Top-down therapy for IBD: rationale and requisite evidence. Nat Rev Gastroenterol Hepatol. 2010; 7(2): 86-92[DOI][PubMed]
  • 30. Bressler B, Marshall JK, Bernstein CN, Bitton A, Jones J, Leontiadis GI, et al. Clinical practice guidelines for the medical management of nonhospitalized ulcerative colitis: the Toronto consensus. Gastroenterology. 2015; 148(5): 1035-1058 e3[DOI][PubMed]
  • 31. Colombel JF, Sandborn WJ, Rutgeerts P, Enns R, Hanauer SB, Panaccione R, et al. Adalimumab for maintenance of clinical response and remission in patients with Crohn's disease: the CHARM trial. Gastroenterology. 2007; 132(1): 52-65[DOI][PubMed]
  • 32. Rutgeerts P, Van Assche G, Sandborn WJ, Wolf DC, Geboes K, Colombel JF, et al. Adalimumab induces and maintains mucosal healing in patients with Crohn's disease: data from the EXTEND trial. Gastroenterology. 2012; 142(5): 1102-1111 e2[DOI][PubMed]
  • 33. Ben-Horin S, Chowers Y. Review article: loss of response to anti-TNF treatments in Crohn's disease. Aliment Pharmacol Ther. 2011; 33(9): 987-95[DOI][PubMed]
  • 34. Molander P, Farkkila M, Kemppainen H, Blomster T, Jussila A, Mustonen H, et al. Long-term outcome of inflammatory bowel disease patients with deep remission after discontinuation of TNFalpha-blocking agents. Scand J Gastroenterol. 2016; : 1-7[DOI][PubMed]
  • 35. Panaccione R, Ghosh S, Middleton S, Marquez JR, Scott BB, Flint L, et al. Combination therapy with infliximab and azathioprine is superior to monotherapy with either agent in ulcerative colitis. Gastroenterology. 2014; 146(2): 392-400 e3[DOI][PubMed]
  • 36. Sandborn WJ. Tailoring treatment to the individual patient: drug monitoring. Dig Dis. 2014; 32 Suppl 1: 88-91[DOI][PubMed]
  • 37. Wu XR, Mukewar S, Hammel JP, Remzi FH, Shen B. Comparable pouch retention rate between pediatric and adult patients after restorative proctocolectomy and ileal pouches. Clin Gastroenterol Hepatol. 2014; 12(8): 1295-302[DOI][PubMed]
  • 38. Bek S, Nielsen JV, Bojesen AB, Franke A, Bank S, Vogel U, et al. Systematic review: genetic biomarkers associated with anti-TNF treatment response in inflammatory bowel diseases. Aliment Pharmacol Ther. 2016; 44(6): 554-67[DOI][PubMed]
  • 39. Boyapati RK, Kalla R, Satsangi J, Ho GT. Biomarkers in Search of Precision Medicine in IBD. Am J Gastroenterol. 2016; 111(12): 1682-90[DOI][PubMed]
  • 40. Broussard JL, Devkota S. The changing microbial landscape of Western society: Diet, dwellings and discordance. Mol Metab. 2016; 5(9): 737-42[DOI][PubMed]
  • 41. Leone V, Chang EB, Devkota S. Diet, microbes, and host genetics: the perfect storm in inflammatory bowel diseases. J Gastroenterol. 2013; 48(3): 315-21[DOI][PubMed]

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .
Readers' Comments