Marian Bátovský
The advent of anti-tumor necrosis factor-alpha therapy has been major advance in the medical maganement of inflammatory bowel diseases (IBD). More recently, infliximab and adalimumab have been shown to be effective for the induction and maintenance of remission in patient with moderate to severe IBD, while certolizumab pegol is effective for the maintenance of remission in patients who have responded to certolizumab-induction therapy. This class of medication is currently the most effective treatment option available for IBD. However, a significant proportion of patients with IBD do not respond adequately to treatment with these agents. Primary and secondary non-response to anti-TNF-alpha therapy represents a common clinical challenge, and highligts the need for the development of additional medication options for IBD patients. Patients with a primary non-response are unlikely to benefit from switching to a second anti-TNF-alpha agent. Patients who develop a secondary non-response also have a lower response rates when switching to a second or third anti-TNF-alpha agent. All of these considerations require the development of less toxic, better tolerated, and more efficacious and cheaper drugs. From this point of view shows golimumab as very promissing for patients with ulcerative colitis. Recent studies demostrated also promissing results of the other therapeutic approaches, non-oriented on anti-TNF-alfa receptors. Above all this group contains preparates with anti-interleukins and anti-integrins activity and also inhibitors of Janus kinases.