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Managing Risks with Biologics

  • Inflammatory Bowel Disease (S Hanauer, Section Editor)
  • Published:
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Abstract

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.

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  1. Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, OH, USA

    Benjamin Click & Miguel Regueiro

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  1. Benjamin Click
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  2. Miguel Regueiro
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Correspondence to Miguel Regueiro.

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Miguel Regueiro reports personal fees from Abbvie, Janssen, UCB, Takeda, Pfizer, Seres, and Allergan, outside the submitted work. Miguel Regueiro serves as a consultant and advisory boards for Abbvie, Janssen, UCB, Takeda, Miraca, Pfizer, Celgene, and Amgen. He also receives research support from Abbvie, Janssen, and Takeda.

Benjamin Click declares no conflict of interest.

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Click, B., Regueiro, M. Managing Risks with Biologics. Curr Gastroenterol Rep 21, 1 (2019). https://doi.org/10.1007/s11894-019-0669-6

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