Biological therapies in inflammatory bowel disease

The management of inflammatory bowel disease has evolved over the last decade with the increasing use of immunomodulators and a shift away from reliance on corticosteroid therapy. As our understanding of the molecular basis of persistent inflammation in the gut advances, new and promising medical therapies to treat inflammatory activity are emerging. Anti-Tumour Necrosis Factor (TNF) therapies form the most significant biological strategy so far but the targeting of other key cytokines, adhesion molecules and use of growth factor peptides offer alternative approaches. In addition, there is considerable interest in disease modification with reduction of hospitalization and need for surgery as well as earlier therapy with biological agents. We review the scientific basis for these therapies and the evidence supporting their use focusing particularly on human studies.