Therapies in Inflammatory Bowel Disease Patients with Extraintestinal Manifestations

Digestion. 2020:101 Suppl 1:83-97. doi: 10.1159/000502816. Epub 2020 Feb 17.

Abstract

Extraintestinal manifestations (EIM) have become an important source of morbidity and disability as well as an identified risk factor for an unfavorably course of disease in inflammatory bowel diseases (IBD). Therefore, efforts have been put into a more global and interdisciplinary management of IBD patients in collaboration with rheumatologists, dermatologists, and ophthalmologists. A real therapeutic success has also been obtained with a more "systemic" IBD treatment associated with the development of monoclonal antibodies against TNF alpha and biological agents derived from the treatment of rheumatological disease (also called biological Disease-Modifying Antirheumatic Drugs). The prevalence of these EIM remains too low to undergo randomized controlled trials with this specific focus and therefore the evidence relies on case series and experts' opinions, which lowers the level of evidence. After a careful review of the most recent literature, this paper aims to update the reader on the latest therapeutic management of IBD patients with EIM.

Keywords: Ankylosing spondyloarthritis; Crohn’s disease; Extraintestinal manifestations; Inflammatory bowel disease; Infliximab; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal
  • Colitis*
  • Humans
  • Inflammatory Bowel Diseases* / complications
  • Inflammatory Bowel Diseases* / drug therapy
  • Tumor Necrosis Factor-alpha

Substances

  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha