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New Strategies Needed for Crohn's Disease

Review authors foresee era in which novel biological agents supplant anti-TNF agents

MONDAY, July 7 (HealthDay News) -- Although anti-tumor necrosis factor agents have benefited patients with Crohn's disease, their variable effects demonstrate that new strategies are needed, according to a review article published in the July 5 issue of The Lancet.

Laurent Peyrin-Biroulet, M.D., of the Universitaire de Lille in Lille, France, and colleagues conducted a database search of articles published between 1966 and March 2008, and hand-searched abstracts presented at medical conferences between 2003 and 2007. They reviewed current data on the mechanisms, efficacy and adverse effects of investigational drugs, and discussed future directions in the treatment of Crohn's disease.

The researchers state that -- apart from anti-tumor necrosis factor agents -- only anti-adhesion molecules have shown efficacy in Crohn's disease. The authors discuss potential new therapies such as humanized or chimeric monoclonal antibodies, a new class of antibodies called avimers (from avidity multimer), and molecules with a high ratio of cannabidiol to tetrahydrocannibinol.

"As a result of decades of intensive research, treatment for inflammatory bowel disease is undergoing a transition from the era of tumor necrosis factor antagonists to an era of novel biological agents, including those that are able to stimulate the innate immune system," the authors write. "In parallel, clinicians are working on new strategies aimed at modification of the natural history of Crohn's disease, including an early aggressive therapeutic approach."

Several of the researchers report receiving fees from pharmaceutical companies.

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