INTESTINE Vol.22 No.3(3)

Theme Recent advance in the treatment of IBD based on the pathogenesis
Title Anti-tumor necrosis factor (TNF)-α agents
Publish Date 2018/05
Author Ken Takeuchi Department of Internal Medicine, Sakura Medical Center, Toho University
[ Summary ] Anti-tumor necrosis factor (TNF)-α agents have had a tremendous impact on clinical practice since they were first introduced for the treatment of inflammatory bowel disease (IBD). Currently, there are several anti-TNF-α agents which are being used in clinical settings in Japan. Those agents have characteristics which must be understood before using them, including different administration methods. However, different immunogenicity levels due to production methods exist. It should be understood that those agents also have slightly different levels of effectiveness when treating Crohn's disease or ulcerative colitis. For the optimal use of anti-TNF-α agents, we should consider the necessity of using an immunomodulator in combination with individual anti-TNF-α agents. Cases of loss of response occurring during the continuous treatment with anti-TNF-α agents for IBD, have recently been reported in Western countries. Alterations of treatment, based on therapeutic drug monitoring (TDM) are the optimal solution for this problem. It is necessary to consider the induction of TDM for anti-TNF-α agent therapy in Japan.
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