Terapia biológica y moduladores del sistema inmunológico en el tratamiento de las enfermedades inflamatorias intestinales

Abstract

Background: Inflammatory bowel diseases (IBD) are chronic disorders of the gastrointestinal tract with no definitive cure. Incidence and prevalence vary according to the disease and geographic location.

Objective: to describe biological therapy and immune system modulators in the treatment of inflammatory bowel diseases.

Methodology: a narrative literature review will be carried out, including scientific articles collected from different databases such as Medline, Lilacs, TripDataBase, Cochrane Library, Epistemonikos, Scopus, by means of identification-typing-eligibility-selection and based on the Scimago Journal Rank quality ranking.

Results: In Crohn's disease, the effectiveness of treatments varies, with Infliximab, Ustekinumab and Adalimumab standing out in different aspects. Vedolizumab stands out in ulcerative colitis. Anti-TNFs show effective mucosal healing. Vedolizumab shows promise in response, remission. Methotrexate has mixed effects. In IBD management, biologics improve quality of life, but have higher costs and different cost-effectiveness ratios. There are also differences in risks of serious infections and lymphoma according to the treatments used. The management of this pathology presents significant challenges, including the lack and loss of response to anti-TNF-α therapies. The choice of treatment depends on multiple factors, including prediction of response, age, gender, and cost-effectiveness. Biopharmaceutical delivery, adherence, and withdrawal of monotherapy are crucial aspects to consider in care.