Risk of Infections of Biological Therapies with Accent on Inflammatory Bowel Disease

Authors

  • Radu M Nanau Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, and In Vitro Drug Safety and Biotechnology
  • Lawrence E Cohen Division of Gastroenterology, Sunnybrook Health Science Centre, and Departments of Internal Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Manuela G Neuman Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, and In Vitro Drug Safety and Biotechnology

DOI:

https://doi.org/10.18433/J3GG6D

Abstract

Background: Biological therapies using anti-tumor necrosis factor (TNF)-α agents have an important impact in the treatment of inflammatory bowel disease, rheumatoid arthritis, psoriasis, and other inflammatory conditions. However, a significant number of patients lose their response to these medications over time. Clinical trials have demonstrated that antibodies against anti-TNF agents may impact treatment response and increase the risk of infusion reactions. Of concern is also the possibility of developing adverse events induced by anti-TNF agents. The purpose of the present systematic review is to describe the current knowledge on the risk of infections associated with anti-TNF agents antagonists, as well as integrin antagonists. We also intend to describe case reports of these adverse events in inflammatory bowel disease patients. Methods: Currently approved anti-TNF biologicals in IBD include the monoclonal antibodies infliximab, adalimumab, certolizumab pegol and golimumab. Integrin antagonists include natalizumab, etrolizumab and vedolizumab. Results: The most frequently-reported adverse events of these biologicals were infections, and these are described in detail in this study. Discussion: Most adverse events are due to the failure of host immunological control, which involves de novo infection, or reactivation of latent bacterial or viral infection, often with a different expression of disease. Conclusion: Risk assessment in individuals undergoing treatment with biologicals represents a step towards achieving treatment personalization to identify those patients that will safely benefit from this therapeutic approach. Patients and physicians must be alert for anti-TNF agents and anti-integrin medication as potential causes of drug-induced infections and monitor the therapies. Personalizing therapeutic vigilance promises to optimize benefits while minimizing infections.

This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

Downloads

Download data is not yet available.

Author Biography

Manuela G Neuman, Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, and In Vitro Drug Safety and Biotechnology

CEO In Vitro Drug Safety and Biotechnology

Ass. Prof. Pharmacology and Toxicology, University of Toronto

Downloads

Published

2014-10-30

How to Cite

Nanau, R. M., Cohen, L. E., & Neuman, M. G. (2014). Risk of Infections of Biological Therapies with Accent on Inflammatory Bowel Disease. Journal of Pharmacy & Pharmaceutical Sciences, 17(4), 485–531. https://doi.org/10.18433/J3GG6D

Issue

Section

Review Articles