The 27th United European Gastroenterology Week took place in Barcelona, Spain in October, at which some of the leading experts in gastroenterology spoke about their field. One of the main topics was inflammatory bowel disease and the medicines and methods used to treat it. Anti-TNF-α therapy was discussed, as biologic therapies are a newer form of treatment that are not as well known as some of the staples of treatment for IBD. 4 experts spoke of this therapy and its place in the treatment of IBD.
About Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease (IBD) is an umbrella term used for a group of disorders characterized by chronic inflammation in the digestive tract. This group includes conditions like Crohn’s disease and ulcerative colitis.
The exact cause of IBD is unknown, but many suspect that it has to do with a malfunction of the immune system. Healthcare professionals believe that an abnormal response of the immune system is triggered when it attempts to fight off viruses or bacteria, which then causes the system to attack the cells within the digestive tract.
While the cause is unknown, there are risk factors that are known to lead to or aggravate the disease. These factors include diet, stress, cigarettes, and nonsteroidal anti-inflammatory medications. Age is another factor, as the majority of people are diagnosed with IBD before age 30. This disease affects mainly white people, and people of Ashkenazi Jewish descent are at an even higher risk. If one has a family history of IBD, there is a higher likelihood that they will develop this disease. Location can also affect IBD, with those living in industrialized countries or northern climates have a higher chance of developing it.
Symptoms of inflammatory bowel disease vary with the location and severity of inflammation. Many people experience periods of active symptoms followed by periods of remission. These active symptoms include diarrhea, fever, fatigue, abdominal pain, cramping, blood in stool, loss of appetite, and unintentional weight loss. Seeking treatment is important as complications of this disease include colon cancer, blood clots, primary sclerosing cholangitis, and inflammation of the eyes, joints, and skin.
The Meeting on Anti-TNF-α Therapy
Four professors spoke at this meeting, all highlighting important aspects of anti-TNF-α therapy. Professor Remo Panaccione spoke first, and he stated that biologic therapies are under-utilized as a whole, and that too few patients actually reap the benefits of this therapy. While he acknowledged that the cost is high and the lack of awareness of patients and physicians, he firmly believes that more patients should be treated with biologic therapy, especially earlier in their treatment. In his experience he has found that anti-TNF-α therapy brings slower disease progression, better outcomes, and less complications.
Professor Thomas Ochsenkühn stresses the importance of early intervention with this therapy. He has found that if biologic therapy is administered too late in the treatment process, then it loses its effectiveness, as structural damage has already occurred. He stresses that people who have aggressive IBD with high-risk factors should use anti-TNF-α therapy as soon as possible.
Professor Stefan Schreiber discussed the safety of this treatment, as well as the price. He said that he is confident in using this therapy to treat people, and that he believes that more physicians should follow his lead. As the price of treatment is a concern for many, he stated that affordable biosimilars will increase access, allow for higher doses, and allow people to access treatment sooner.
Professor Jonas Halfvarson spoke last at this meeting. He has plenty of experience with this form of treatment, and he has also switched patients from originators to biosimilars in his career. He stated that this switch brought no issues with safety. While he found that switching treatments was completely safe, he stressed that communication between the patient and doctor is absolutely necessary. The patient should understand their treatment just as well as their physician does.
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